When leveraged as one part of a multi-pronged specialty pharmacy solution, the comprehensive approach to alternative funding may better meet clients’ unique needs by tackling rising costs and risks
RxBenefits, the employee benefits industry’s first technology-enabled pharmacy benefits optimizer (PBO), is proud to announce the launch of its new Patient Assistance solutions. Designed to complement RxBenefits’ comprehensive suite of pharmacy solutions, these alternative funding offerings can help reduce specialty drug costs for some patients and plans.
Specialty medications provide breakthrough – sometimes life-saving – treatments for complex, chronic, and rare diseases; however, the cost of these drugs can be prohibitive for self-funded plans. In fact, specialty drugs account for approximately half of U.S. pharmacy drug spend. When such costly drugs are required, plan sponsors are challenged with supporting members and providing a positive experience. RxBenefits’ Patient Assistance solutions address key shortcomings of current patient assistance offerings while also alleviating the financial strain for plan sponsors and patients alike.
With these solutions, patients receive their medications, even if alternative funding is unavailable or the patient doesn’t qualify for need-based assistance. The solutions can offer substantial savings opportunities in the right situations where other market alternatives fall short. These Patient Assistance solutions uphold the RxBenefits approach, ensuring members have a quality service experience while getting the medications they need based on necessary clinical oversight. In keeping with the company’s client-aligned business model, RxBenefits does not receive any fees or commissions related to these solutions.
“At RxBenefits, we leverage our negotiating power, clinical expertise, and exceptional service to do what’s right for our clients and their members,” said Wendy Barnes, CEO, RxBenefits. “These Patient Assistance solutions improve clinical oversight and the member experience for alternative funding options.
“This solution set is just one piece of the specialty management puzzle,” Barnes added. “There is no single solution to managing specialty drug costs. A multi-pronged approach to address both specialty drug spend and volatility is critical to doing what’s right for patients by making specialty drugs more accessible and affordable for them and plan sponsors.”
In addition to the new Patient Assistance solutions, the RxBenefits comprehensive specialty pharmacy approach also includes:
- Optimize 360: RxBenefits’ flagship solution handles every aspect of the pharmacy process, from initial contract negotiations to ongoing plan support and exceptional client and member service. RxBenefits’ client-aligned contracts pass 100% of scaled discounts and rebates to the plan.
- RxBenefits Protect: A solution that delivers independent clinical expertise, oversight, and intervention to eliminate wasteful spending while protecting the health and safety of plan members. Protect programs are designed and led by independent PharmDs to ensure the plan pays for appropriate and necessary medications, and nothing more.
- RxPharmacy Assurance: Self-funded employers face skyrocketing prescription benefit costs driven almost exclusively by specialty drug claims. RxPharmacy Assurance mitigates risk from high-cost specialty drug claims and may reduce traditional stop-loss premiums.
Patient Assistance solutions – used in tandem with RxBenefits Protect – provide two options to maximize the benefits of alternative funding while still ensuring patients receive medication quickly. Both options cut costs by tapping into available drug manufacturer assistance dollars, helping vulnerable members access medically necessary and appropriately prescribed high-cost specialty medications. As with any benefit option, Patient Assistance solutions should be evaluated on a case-by-case basis, because not every plan would benefit. RxBenefits can conduct a no-obligation, in-depth analysis for plans to account for money lost from manufacturer rebates if Patient Assistance solutions are considered.
“Self-funded plans require a comprehensive, layered approach to managing specialty spend, and the utilization of alternative funding is one more way RxBenefits helps self-funded plans save on specialty drugs,” said Mark Campbell, SVP of Clinical Solutions, RxBenefits. “We’re excited to work with our preferred providers to ensure available and appropriate savings are passed along to patients and plans.”