Specialty Pharmacy Collaboration Improves Access to Hepatitis C Drugs

A coordination program between a specialty pharmacy and specialty clinics helped to promote and improve access to direct acting antiviral therapies for hepatitis C, according to an abstract presented at the 2016 NASP Annual Meeting.

“Direct-acting antiviral therapies are effective treatments for hepatitis C virus,” Cara Joyce, PhD, director of Biostatistics Core at Loyola University Chicago, and colleagues wrote. “Access to direct-acting antivirals can be negatively impacted by high costs, insurance coverage, and complex patient management.”

The researchers studied a collaboration between Walgreens Local Specialty Pharmacies and clinical practices that aimed to reduce access barriers to direct-acting antivirals by issuing prior authorization requests, appeals, copays, and by sending refill reminders. They conducted a descriptive retrospective study using the pharmacy database for hepatitis C patients who were prescribed direct-acting antivirals. The study data were from a liver clinic at the Piedmont Atlanta Hospital. Of the 388 eligible study participants, data were available for 94%. 

Study results showed that although 62% of study participants were able to fill direct-acting antiviral prescriptions, 38% were required to fill the prescriptions at non-local specialty pharmacies because of insurances requirements. 

While 22% of participants were initially denied coverage for direct-acting antivirals, 64 appeal letters drafted through the collaboration resulted in 8% of denied patients eventually getting approval. 

Results also showed that through the programs’ copay assistance requests, copays of more than $20 decreased to $5 or less for 63 patients, while full financial assistance was granted to 20 study participants with no direct-acting antiviral coverage.

“Collaboration between providers and local specialty pharmacies minimized delay in therapy, lowered rates of direct-acting antiviral denial, and maximized patient financial assistance,” Dr Joyce and colleagues concluded.  — David Costill