JL524. Pharmacy Financial Advocacy: Benefits of a Pharmacy Financial Advocate in the Oncology Clinic
Joe Weber, PharmD, BCOP, Lynnette Coolidge, PharmD, BCPS, BCOP, Kayla M. Hinsch, CPhT, and Kelly Carlson, RN, BS, MHA; Oncology Pharmacy, Sanford Cancer Center, Sioux Falls, South Dakota
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JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017
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Background: Comprehensive cancer care is often built on medical and psychosocial models. However, it is not uncommon for cancer programs to dismiss the importance of financial patient advocacy during the cancer journey. Increases in the number of new treatments approved by the Food and Drug Administration (FDA), along with established, complex oral and intravenous chemotherapy regimens, pose significant financial risk to both patients and the institutions that treat them. The numbers of patients unable to receive treatment due to financial constraints is increasing. There are several avenues available to help the patient successfully access chemotherapy and specialty medicines, however, an organization must be willing to commit resources to maximize the financial opportunities available. The purpose of this project was to decrease patient out-of-pocket expenses for oncology treatments through the development of a pharmacy financial advocacy program.
Intervention: This project was a process improvement project set at a tertiary care cancer center located in the Midwest. A dedicated financial advocacy program was established within the cancer center pharmacy, July 2014. The intent of the financial advocacy program was two-fold: (1) Develop expertise in the use of existing resources and (2) develop a process for seeking out new and alternative sources of funding. Dollars saved through co-pay assistance programs, free drug programs, and foundation assistance programs were tracked monthly.
Results: $91,000 in savings to patients and alternative revenue sources to the clinic was realized in the first month of the program. Within a year, the program transitioned from a shared role to a dedicated person maximizing the efficiencies. The pharmacy financial advocacy program has grown to an average savings of $423,000 monthly for all patient populations served within this program. The savings for FY17 totaled over $5,000,000.
Conclusion: Prior to the implementation of the pharmacy financial advocacy program, financial constraints were the main drivers in a patient’s decision as to whether he/she was going to proceed with treatment. As the role and program developed, so did the knowledge base and resources of the financial advocate. Utilizing foundations and financial assistance programs significantly decreased the patient’s out-of-pocket expenses and financial burden for chemotherapy treatments and other specialty medications.
Implications: A dedicated pharmacy financial advocate allows a comprehensive cancer center the opportunity to serve patients better, do the right thing, and limit financial risk to both the patients and the organization.
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