Editor’s Note: At the 2022 Asembia Specialty Pharmacy Summit, our CEO Srulik Dvorsky presented alongside Sarah Freedman, Senior Manager, Specialty Pharmacy Operations at Walgreens. Srulik and Sarah discussed the financial burden of specialty drugs for patients, providers, and pharmacies. Highlighting the partnership between TailorMed and Walgreens, they shed light on how technology can help pharmacies reduce costs, improve patient outcomes, and boost financial performance.
Watch the video above to view the full presentation and read the post below to learn more.
In recent years, the utilization of specialty drugs has grown exponentially. Specialty drugs make up 80% of all new drug approvals, and an additional 400 specialty medications are expected to be approved by the FDA in 2022.
Patients with complex, chronic, or rare diseases rely on the therapeutic benefits of specialty drugs, but the high costs can be a prohibitive barrier that prevents many from accessing the lifesaving medications they need. Though specialty medications account for less than 2% of prescriptions throughout the U.S., they account for 52% of pharmacy drug spend. The impacts of high drug costs are far-reaching and a growing concern in the specialty pharmacy arena.
The impact of high-cost specialty drugs
At 61 years old, Nancy lives with multiple sclerosis. She takes Avonex to slow the progression of the disease and reduce her symptoms. But living on a fixed income, Nancy struggles to adhere to her treatment protocol, which costs her $3,320 out-of-pocket each month.
Nancy’s story is far from unique. Millions of patients living with chronic, complex, or life-threatening diseases struggle to afford expensive specialty drugs. In fact, nearly 50% of patients with chronic conditions do not take their medications as prescribed.
When patients like Nancy abandon their prescriptions, it can have devastating effects on their health. Medication nonadherence is associated with higher rates of hospital admissions, poorer health, and over 275,000 deaths each year.
It isn’t just patients who feel the sting of these exorbitant costs. Alison, Nancy’s healthcare provider, has seen a decrease in therapy adherence in her patients who take specialty drugs. Though she discusses financial assistance options with patients, coordinating and following through is both time-consuming and logistically challenging. Providers know that nonadherence leads to worsened patient outcomes, and many are left with high levels of uncompensated care.
Pharmacists and specialty pharmacies are equally impacted. Jana, a specialty pharmacist, is increasingly concerned about the growing number of patients who abandon their prescriptions. Higher out-of-pocket costs are associated with higher rates of prescription abandonment. Less than 5% of prescriptions are abandoned when there is no out-of-pocket cost but rise to 45% when the cost is $125 and 60% when the cost is over $500.
Jana spends a considerable amount of time helping financially at-risk patients access the medications that are vital to their health and wellbeing. But as more patients require high-touch, high-cost medications, it has been challenging for her to assist every patient.
Specialty pharmacies face significant revenue loss as a result of prescription abandonment. Overall, medication nonadherence costs the healthcare system an estimated $672.7 billion each year. As specialty pharmacies continue to see an influx of new and expensive specialty drugs — and an uptick in the number of patients who need them — there is an urgent need for solutions that address and solve the specialty drug affordability problem.
Digital solutions to solve a complex problem
New and emerging technologies have a vital role to play in removing financial barriers and increasing access to specialty drugs. What is often an inefficient, fragmented, and expensive financial navigation process can now be automated with the help of digital solutions. For example, specialty pharmacies are often unaware of a patient’s need for financial assistance until after their prescription has been adjudicated and they are unable to afford their co-pay. Technology can help pharmacy staff identify at-risk patients on the front end, connect them with cost-saving resources, and reduce both prescription abandonment and time spent on manual tasks.
TailorMed’s solution uses predictive analytics to proactively flag at-risk patients and provides an out-of-pocket cost estimation for the entire medical journey. It then automates the process of identifying and enrolling patients in relevant financial resources, such as disease-specific foundation grants, free and replacement drug programs, and drug manufacturer co-pay assistance.
Our partnership with AllianceRx Walgreens Prime demonstrates how specialty pharmacies can leverage technology to improve patient outcomes as well as financial performance. Using TailorMed’s platform, more than 300 Walgreens specialty pharmacies across the U.S. have the means to efficiently and effectively help financially vulnerable patients access specialty drugs. As a result, Walgreens pharmacists and other staff have more time to connect with and educate patients, which is of particular importance for patients taking specialty drugs. At Walgreens, TailorMed has enabled specialty pharmacies to streamline operations and increase savings; last year, Walgreens secured more than $700 million in patient financial assistance.
Harnessing the power of the network
Proactive collaboration across the continuum of care is the key to solving the specialty drug affordability problem. Historically, patients, providers, and specialty pharmacies have relied on cumbersome, manual processes to secure patient financial assistance. In a recent survey, 69% of specialty pharmacists report that such administrative tasks take away from direct patient care activities. Healthcare systems and pharmacies have progressively become more strained for resources and time, stuck in silos that require extensive outreach and time they don’t often have.
TailorMed brings together the market’s largest network of providers, pharmacies, life science companies, and charitable foundations – united by the common goal of removing financial barriers to care. By leveraging an established network driven by powerful technology, organizations like Walgreens are empowered to break down silos, improve communication across the entire continuum, and secure financial resources for more patients in need.
Addressing a patient’s financial health is a critical component of delivering holistic, integrated care. As TailorMed’s network continues to expand, Walgreens and other pharmacy partners will be better equipped to support patients at every prescription encounter.
Improving outcomes across the continuum of care
When it comes to specialty drug affordability, financial navigation technology helps improve outcomes for all. By reducing financial hardship, patients can more easily adhere to their treatment plans, leading to better clinical outcomes. Digital solutions also help empower patients, giving them the confidence needed to make informed decisions and act as managing partners in their healthcare.
With pharmacist burnout rates at an all-time high, technology reduces the strain and time constraints many pharmacists, technicians, and other staff find themselves under. These solutions empower pharmacy staff to efficiently assess each patient’s ability to pay and match them with appropriate funding. Robust financial insights also enable pharmacies to develop data-driven strategies that cut costs, reduce prescription abandonment, and boost financial performance.
Software solutions to streamline, save, and serve
Technology bridges the specialty drug accessibility gap and reduces the financial burden of care. TailorMed and Walgreens’s joint effort to help address cost barriers benefits patients, providers, and pharmacists alike.
Patients like Nancy can access vital medications without having to choose between lifesaving treatment and paying their rent, mortgage, or other living expenses. Providers like Alison are more confident their patients can afford and follow recommended treatment protocols. And specialty pharmacists like Jana have the tools they need to automate and accelerate the prescription journey, freeing up their time to connect with patients on education and support.
We look forward to our continued partnership with Walgreens and other pharmacy partners, as we work together to remove financial barriers, increase medication adherence, and help more patients access the care they deserve.