In recognition of Hepatitis Awareness Month, we’re sharing a unique story from one of our partners that highlights how a clinic-based health system specialty pharmacy enhances patient care and enables population health initiatives that improve access to therapy.
More than 3 million people in the United States are living with hepatitis C, and there are around 17,000 new hepatitis C cases each year.1 New specialty medications for hepatitis C can lead to cure rates of over 95 percent when taken as prescribed.
However, when these therapies were first introduced, many health plans only approved them for patients with high fibrosis scores. This meant many patients weren’t able to access treatment.
Recently, health plans have started loosening fibrosis restrictions, allowing patients previously unable to access therapy to obtain treatment. However, because patients aren’t always aware of these changes, health systems must proactively identify and engage them.
Working with providers to identify and engage patients previously denied therapy
When a health plan in Oregon loosened its fibrosis restrictions, a specialty pharmacy liaison at one of our partner health systems identified patients who were previously unable to access therapy. This required reviewing electronic health records to identify patients diagnosed with hepatitis C – something the liaison was able to do because he is an in-clinic care team member.
After identifying eligible patients, the liaison began encouraging their physicians to reconsider treatment. He personally met with doctors and residents about a recommended approach to patient outreach and engagement. His work was successful – the physicians agreed and the liaison began arranging face-to-face meetings with patients to discuss therapy.
Addressing barriers to care to ensure a patient can continue therapy
Shortly after beginning therapy as a result of the liaison’s efforts, one patient learned she was losing insurance coverage. The patient notified the liaison and he immediately began working on a solution so she could complete therapy.
The liaison first contacted the patient’s health plan directly, but they were unable to extend her coverage. He then reached out to his established contact at the drug manufacturer, who, based on his knowledge of the health system’s program and the explanation of the patient’s situation, promptly sent a financial assistance application.
The liaison worked with the patient to get necessary documentation and to submit her application. Within days, she was approved. This meant she was able to continue and ultimately complete her therapy with no interruptions.
Strong relationships set clinic-based specialty pharmacy services apart
This story highlights the benefits of embedding pharmacists and pharmacy liaisons directly in your health system’s specialty clinics. When asked about this experience, the pharmacy liaison emphasizes the advantages of a clinic-based approach saying:
“I have worked as a pharmacy liaison for over ten years. In my previous roles, I was based out of call-centers and only interacted with patients over the phone. With Trellis Rx, I work alongside other care team members. This allows me to communicate with providers and patients face-to-face. As a result, I build strong relationships that foster the trust needed to enhance patient care and outcomes.”