Q&A: Wrapping up ways to make specialty medication prescribing easier

Hub Services

On May 24, two of ConnectiveRx’s subject matter experts participated in a panel discussion about the use of non commercial pharmacies as a way to make the prescription process faster and easier for healthcare providers. Our attendees asked fantastic questions, but we weren’t able to address them all.

 

Chris Dowd and Natalie S. Tyler took the time to provide their answers to some of those questions, including ways that Careform Pharmacy powered by ConnectiveRx can help address the points brought up below.

You can also check out the full conversation, A Simple Way to Give HCPs the Power to Prescribe Your Specialty Med, which is now available on-demand.

What would you say are the biggest benefits of using a non-dispensing, non-commercial pharmacy, compared to the traditional specialty prescribing process?

Natalie: A streamlined non-dispensing pharmacy such as Careform Pharmacy can help the prescriber save time because it allows them to stay within the patient’s EHR workflow and send the prescription from one place, rather than asking them to continuously log into and learn other portals or submit faxed forms.

Some of the other top benefits clients have noted include:

  • E-prescriptions contain all of the required information necessary to run e-eligibility, so there is no need to complete additional forms

  • A clean prescription to the NCP will quickly kick off Benefit Verification (BV)/Prior Authorization (PA) services for patient access. Significant time is saved due to the electronic input of data needed to kick of BV and PA services, as well as the reduction of hard to read handwriting and missing or incomplete information scenarios commonly experienced with faxed forms

  • The enrollment process is streamlined for the prescriber by removing the hassle of trying to figure out which pharmacy to send the patient’s prescription for a specialty drug

Isn’t it true that ConnectiveRx only works with a subset of EHRs? If this is the case, how do providers outside of the CRx network use the non-commercial pharmacy?

Chris: This question brings up a great opportunity to differentiate between two distinct EHR touch points, and what happens to be two ConnectiveRx pharma solutions.

First, we run the largest available EHR adherence and compliance messaging service (network of more than 500,000 prescribers).  In fact, we recently partnered with Veradigm/Allscripts for exclusive access to their premier EHR platforms. So, think of this has a channel to reach HCPs for a brand message on anything from product information, disease state or coupons, all while they are working on their EHR.

This, however, is separate from our non-commercial pharmacy connectivity. In this e-prescription event, every EHR in the US has access to Careform Pharmacy. This means any healthcare provider, regardless of whether they are within our network or not, can prescribe your brand simply by selecting Careform non commercial pharmacy, in the same way they would select the local CVS, for example.

When the prescriber sends the enrollment to Careform Pharmacy, who then forwards the enrollment to a dispensing pharmacy, is the dispensing pharmacy able to use the enrollment without having to reach out to the original prescriber?   

Natalie: Overall, the answer is yes, the dispensing pharmacy is able to complete the prescription process without reaching out to the prescriber because they already have all of the information they need to complete the fill. Simply put, the process is as follows:

  1. Prescriber sends e-prescription to Careform Pharmacy

  2. Careform enters all data into the pharmacy management system, handles Benefit Verification and Prior Authorization requirements, and assigns a prescription number

  3. Careform conducts a pharmacy to pharmacy transfer to the dispensing pharmacy

  4. Dispensing pharmacy accepts the prescription and fills it because it is coming from another pharmacy

The only exception could be if the dispensing pharmacy has an SOP in place or if the pharmacy’s state regulations require a confirmation of the prescription. But even then, the dispensing pharmacy most often will contact Careform, not the original prescriber.

What’s the difference between a patient co-pay program and a patient assistance program? Are they one and the same?

Chris: The specific language around these two programs is often confused, but in reality there are very specific and important differences:

  Patient assistance program (PAP) Copay assistance program
Who is the program for? Patients who:
Are uninsured
Are at a certain level of income - Perhaps make too much money to qualify for Medicaid but still need help
Are underinsured by an employer
Mostly insured patients needing extra out-of-pocket cost help
What does the program provide? Free goods, either directly shipped or managed through a voucher program A contribution, from pharma, on a processed prescription
Who pays for the program? Drug manufacturer Drug manufacturer
Who can enroll in the program? Can vary by program, but general requirements are:
US citizen
Proof of no insurance or that current insurance doesn’t cover medication
Specific income requirements
Can vary by manufacturer, but generally those who have private health insurance; level of financial hardship is not a factor

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