Although these programs are not the entire solution to rising pharmacy costs, Marsh said they are an important part of solving the problem.
In an interview with Pharmacy Times at the 2023 Asembia Specialty Pharmacy Summit, Josh Marsh, vice president and general manager of Sonexus Access and Patient Support at Cardinal Health, discussed key trends in patient assistance programs. Although these programs are not the entire solution to rising pharmacy costs, Marsh said they are an important part of solving the problem.
Q: What do patient access and patient support services look like?
Josh Marsh: Yeah, absolutely. So, at Cardinal Health Sonexus Access and Patient Support, we're focused on simplifying and allowing patients to get more access to their specialty medications. So, the main services that we offer are reimbursement services, so benefit investigation, prior authorization support, and then the financial assistance components. So, patients who are unable to afford their medication, identifying qualified services for them through the manufacturer, as well as for those patients who are uninsured or underinsured, and qualifying them for patient assistance programs to get a free drug through our non-commercial dispensing pharmacy.
Q: What are key trends that pharmacists should know about regarding patient assistance programs?
Josh Marsh: Yeah, so the first one is the availability of the programs themselves. I've been in this industry for over 20 years and up until 8 years ago, I was actually unaware of these manufacturer-sponsored patient service programs. So, you know, [for] the patients, the pharmacists are identifying a patient who's potentially eligible, educating them on the patient service program so that they can enroll. It’s definitely going to be one thing that I'd like to call out. And then the other one is the technology behind the patient service programs. So, automating as much of the journey as possible, using electronic benefit verification, electronic prior authorization, patient portals, chat bots, to be able to streamline that patient journey so that they can get access to medication faster, is a big trend that we're focusing on right now in this space.
Q: These programs seem to be somewhat in response to growing pharmacy costs, particularly with specialty drugs. Are these programs a potential solution to that problem?
Josh Marsh: Yeah, I would say it's not a full solution. It's definitely part of the solution. So, you know, educating these patients, educating the physicians, the pharmacists on these programs and how they can assist. It doesn't reduce the cost to nothing, but it allows the patient to better understand what their out-of-pocket cost is going to be, what services are available, not just financially but also educationally. The specialty medications have a lot of different times, side effects, services, ancillary services along with the medication, so having a nursing team, having a case manager team that can walk the patients through that. It, again, does not solve the high cost of medications, but it definitely allows us to educate the patient so that they can be better prepared for the journey.