The following post was authored in partnership with NICA partner, SamaCare. Prior authorizations are a burden across all specialties. In fact, in a 2022 survey by SamaCare, 91% of providers reported that prior authorizations have a “highly negative” or “somewhat negative” effect on patient care. Infusion centers face their...
Sometimes, even seasoned healthcare professionals get hung up on the intricacies of the pharmacoeconomics of patient assistance programs. If you’re looking to brush up on the issues associated with patient out-of-pocket cost affordability, look no further. We’ll start with some basics. “Patient Financial Assistance Programs” (PAP) are programs which...
Written by Angie Baker and Stef Parks, Leaders in Patient Access and Reimbursement As many drug manufacturers continue to develop new and innovative therapies for multiple disease states, we continue to see an evolution in the system through which payers (insurance companies/PBMs) use to process and pay claims. Copay...
From the Broomstick of Julie Baak This is the 3rd grade math explanation of how Pharmacy Benefit Managers (PBMs) work: PBM denies $300 drug. They then force the doctor to use the $1200 version made by the same company with a different label, and makes the price $1194. And then,...
The following article is written by Marketing and Communications Coordinator, Cristina Threlkeld for the National Infusion Center Association. Patients rely on easy and affordable access to their medications. Prescribing clinicians and sites of treatment also rely on accessibility and the flexibility to obtain these medications in the most cost-effective...
From the Broomstick of Julie Baak Pharmacy Benefit Managers (PBM) are the middlemen that do none of the work and make most of the money. Fun Fact: PBMs have their MBAs tell MDs which drugs (formulary) they can prescribe based on how much money the PBM can make instead of clinical efficiency and the welfare...
Written by Marissa Shackleton, The Elliot Lewis Center, Wellesley, MA As the Executive Director of a multiple sclerosis center, I believe medications should be accessible and affordable for patients. In order for infusion treatment to be accessible and affordable, patients should aim for a coordinated team approach with their...