Expert Perspectives

3 steps to maximize your Patient Assistance Program

McKesson pharmacy experts share top trends for hospital and health system

By Craig Dolan, PharmD, MBA
VP, Pharmacy Services, McKesson Pharmacy Optimization®

Nearly 28.5 million Americans are uninsured or underinsured, leaving them exposed to medical costs they can’t afford.1 For these patients and the hospitals and health systems that provide their care, Patient Assistance Programs can help relieve financial pressures by offering free medications, devices and co-pay assistance. PAPs also play a critical role in promoting medication adherence and a strong relationship between the patient and the pharmacist.

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According to industry sources, some hospitals and health systems with Patient Assistance Programs (PAPs) have recouped nearly 2–3% of their annual drug spend — a recovery that may measure into the millions of dollars for larger organizations. However, securing this aid can be extremely challenging. PAPs are often complex and difficult to manage. Plus, constantly changing PAP eligibility requirements and an abundance of paperwork can put a significant strain on pharmacy staff time and resources.

With continual changes in PAPs, here are three ways to help your hospital or health system maximize your recovery efforts:

  1. Partner with a PAP expert
    By partnering with a PAP expert, hospitals and health systems can more efficiently explore all options for cost recovery while continuing to provide the highest quality of care. It’s important to look for a partner that has the expertise and ability to manage the entire PAP process — from patient paperwork through reconciliation of drug packaging information and application forms.
  2. Invest in robust PAP software
    Currently, over 80 pharmaceutical manufacturers offer PAPs.2 However, one of the challenges is proactively monitoring manufacturer changes for each program. Manufacturers are also tightening the criteria to qualify for PAPs and requiring more documentation. For pharmacy staff, it’s important to have a system for finding, qualifying, enrolling and tracking patients eligible for PAPs.

    With the right software program, you can alleviate a number of these challenges and save your pharmacy staff valuable time. Today, robust PAP programs offer a wide range of capabilities. For example, they often store patient data, auto-populate required forms, and streamline and track the status of PAP applications.

  3. Have a dedicated in-house resource manage PAPs
    Successful participation in PAPs requires engagement from different hospital or health system departments. It’s beneficial to dedicate an in-house resource to manage PAPs on the intake side of patient care. By determining whether a patient is eligible for a PAP from the beginning of treatment, an in-house resource can identify the therapies needed to treat the patient and what PAPs are available to aid in the patient’s care. Sometimes, if a patient has already started treatment, the opportunity to engage with a PAP has passed. That’s why it’s important that hospitals are on top of PAP management at the time of patient intake.

As healthcare costs continue to increase, caring for disadvantaged patients will have a significant financial impact on hospitals and health systems. With the help of PAPs, your organization can ensure that patients receive the quality, cost-effective medications they need while helping you recover considerable savings.

To learn how McKesson can help improve your pharmacy, email us today.

 

About the author:
Craig Dolan is the VP of Pharmacy Services for McKesson Pharmacy Optimization LLC, a commercial provider of PAP business services to hospitals and health systems nationwide. He completed his bachelor’s degree and his Doctor of Pharmacy degree at Duquesne University as well as a Masters of Business Administration at Monmouth University.

 

Sources:
1 “Key Facts about the Uninsured Population.“, The Henry J. Kaiser Family Foundation, September 29, 2016
2 “Drug company–sponsored Patient Assistance Programs: A viable safety net?“, HealthAffairs, May/June 2009

Note: The information provided here is for reference use only and does not constitute the rendering of legal or other professional advice by McKesson. Readers should consult appropriate professionals for advice and assistance prior to making important decisions regarding their business. McKesson is not advocating any particular program or approach herein. McKesson is not responsible for, nor will it bear any liability for the content provided herein.