Partnership Aims to Lower Out-of-Pocket Costs for Rare Disease Meds

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by Shayna Korol |

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AllianceRx Walgreens Prime/specialty pharma out-of-pocket costs

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AllianceRx Walgreens Prime, a specialty and home delivery pharmacy, is partnering with TailorMed, a healthcare technology company, to help lower out-of-pocket prescription costs for specialty pharmacy patients.

Medications attained through specialty pharmacies are those used to treat rare and chronic conditions in the U.S., and are often extremely costly.

For this reason, Alliance Rx noted in a press release, it has staff dedicated to helping link eligible rare and chronic disease patients with financial aid programs. Company data reported $600 million in aid given to people using it as a specialty pharmacy in 2019 and 2020.

A 14% rise in assistance was also noted for the 2020 year, attributed to increases in therapy and patient out-of-pocket costs.

“While therapies for patients with chronic conditions have evolved greatly, they have done so at a price,” Lisa Mymo, vice president of pharmacy and financial services at AllianceRx Walgreens Prime, said in the release. “Because of the complex and often rare conditions these high-touch drugs treat, they can range in cost from thousands of dollars a month to hundreds of thousands of dollars per year.

“We want to eliminate financial barriers to access and connect our patients with resources to help make these treatments affordable,” Mymo said.

This is of particular importance in ensuring patients are able to access needed therapies, the company noted, citing a 2020 report by the analytics company IQVIA. That report found a 5% rate of non-adherence to prescribed treatment when out-of-pocket costs were zero, and a 45% non-adherence rate when these costs surpassed $125.

A majority of patients, 60%, stopped using treatments as prescribed when out-of-pockets costs exceeded $500.

TailorMed’s platform identifies people at risk of being unable to afford their specialty prescriptions, and automatically connects them to financial assistance programs. Its comprehensive database of financial assistance programs is updated in real-time.

AllianceRx Walgreens Prime will have access to more than 5,000 aid programs via this platform. They include co-pay assistance, manufacturer voucher and bridge programs, government subsidies, community and state resources, and assistance from disease-specific foundations, TailorMed reported in a separate press release.

“Patients mostly want reassurance, respect and the confidence that we will do whatever it takes to help address their concerns,” said John Segina, a group supervisor of Patient Financial Services at AllianceRx Walgreens Prime. “We are helping them get medicine they otherwise would not be able to afford. As long as we are giving this effort for every patient, I believe we are making a difference.”

Segina mentioned one case in which a person’s copay for an asthma medication fell from $4,393 to $5 each month after AllianceRx Walgreens Prime identified a nonprofit foundation that, based on eligibility, was able to help.

“Rising out-of-pocket costs have created financial challenges for patients and pharmacies,” said Bryan Bloom, TailorMed’s director. “The work between AllianceRx Walgreens Prime and TailorMed will address this at scale, helping make specialty prescriptions affordable for patients across the country.”

Added Mymo: “We are excited to leverage TailorMed’s technology to help lower specialty prescription costs for our patients. By improving access to these vital, yet expensive therapies, our patients are more likely to adhere to treatment and better manage their rare disease or chronic conditions.”


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