13 episodes
Prescription for Better Access Mark Hansan and Dr. Scott Howell
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- Health & Fitness
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5.0 • 13 Ratings
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With pharmaceutical and biotech manufacturers launching more high-cost specialty drugs and the insurance industry increasing the use of more restrictive barriers to access, those who need these medicines—the patients themselves—are caught in the middle, not only shouldering the cost of higher copays and deductibles, but for many, rationing or even abandoning treatment altogether.
While manufacturers invest in programs to help navigate the challenges impeding access and affordability, the entire healthcare industry can agree -- the status quo is unsustainable. There has to be a better way. And two industry veterans have joined forces to co-host a new interview-focused podcast to help shape the future of patient access and affordability.
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Episode 12: How Alternative Funding Programs Exploit Patient Assistance Programs
In this episode, we investigate the rise of Alternative Funding Programs (AFPs) that bypass coverage for vital specialty drugs. Kyle Crowell, an expert consultant on AFPs, discusses how payers avoid their responsibility for costs by collaborating with third-party companies to exclude specific drug coverage and directing patients towards manufacturer-sponsored patient assistance programs (PAPs). Patient advocate, Amy Niles from the PAN Foundation, describes how the mounting tension caused by AFPs are leaving patients to navigate the uncertain waters of their medication coverage and access, potentially risking their health and even their lives.
Kyle Crowell, Principal (Partner) at ZS Associates
Amy Niles, Chief Advocacy and Engagement Officer, PAN Foundation
Patient Assistance programs (PAPs)
Alternative funding programs (AFPs)
“AFP Caution For Patients”
“Pharma faces tough choices as alternative funding programs exploit charitable giving”
Medicare Part D
“AbbVie sues a behind-the-scenes company for exploiting its patient assistance program”
Federal Trade Commission
Carl Schmidt from the HIV and Hepatitis Policy Institute
Copay Accumulator Adjustment Programs Lawsuit
Like this episode and want to hear more? Listen to past episodes here!
Do you have a prescription for better access? Share your comments and episode ideas with us at:
comments@prescriptionforbetteraccess.com.
Find us on social media! We’re on X as @RX4BetterAccess, LinkedIn and YouTube.
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Episode 11: Obesity Week 2023: An Interview with Dr. Angela Fitch, President, Obesity Medicine Association
Patients are experiencing remarkable weight loss thanks to the new generation of GLP-1’s and the downstream health benefits may go well beyond diabetes. In spite of the dramatic results for patients, insurance plans have started to put up more barriers and are even denying the drugs on a more consistent basis. For this special Obesity Week 2023 episode, we interview Dr. Angela Fitch, President of the Obesity Medicine Association, a faculty member at Harvard Medical School and most recently a Co-Founder and Chief Medical Officer for knownwell, a new obesity-focused primary care company.
Show Notes:
Dr. Angela Fitch, President, OMA
Obesity Week
Obesity Medical Association
Dr. Fitch’s patient care center: Knownwell
Seeking treatment for obesity? Find a clinician here or here.
The Treat and Reduce Obesity Act of 2023
The drugs discussed in this episode:
GLP-1 (Glucagon-like peptide-1)
Wegovy (Semaglitude)
Victoza (Liraglutide)
An article on the use of “bootlegged” Semaglitude: Demand Rising for 'Bootlegged' Weight-Loss Drug | MedPage Today
Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.
Find us on social media! We’re on X as @RX4BetterAccess, LinkedIn and YouTube. -
Episode 10: Empowering Employers to Improve Patient Access
Employers are discovering this fall that they are expected to shoulder a 6% health insurance increase for 2024. What can employers do to combat the accelerating cost of health insurance without jeopardizing access to vital drugs? In this podcast episode, we talk with Matt Ohrt, a former HR executive who achieved a 20% reduction in health insurance costs for his employer. Matt has a new book and new company to help other self-funded employers strategically lower their sponsored health insurance costs for 2024 while ensuring employees have optimal access to care and treatments. This is an essential listen for employers seeking to balance cost-efficiency with the provision of comprehensive, high-quality healthcare benefits to their employees.
Matt Ohrt, Co-founder, Chief Healthcare Officer, Self Fund Health
Self Fund Health
Merrill Steel
How Does Direct Primary Care Work?
Matt Ohrt’s book: “Save Your Company: Don't Feed the Beast: The Employer Healthcare Success Formula”
Like this episode and want to here more? Check out our past episodes here!
Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com
Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)
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Physician Offices: Fighting for Patient Access
Many of the most beneficial therapies are prescribed or administered within physician offices yet these providers face a multitude of challenges attempting to get authorization and coverage. In this podcast, we interview a practice manager who is not only on the frontlines of the battle to help patients but is also an award-winning advocate for access. This episode will explore the barriers faced by providers and their offices and what can be done to win the day-to-day battles with insurance companies and PBM’s so patients can access and remain on treatment.
Julie Baak, Practice Manager, Arthritis Center
Arthritis Center
Rheumatoid Arthritis
Psoriatic Arthritis
Reactive Arthritis
The importance of ultrasound in identifying and differentiating patients with early inflammatory arthritis: a narrative review.
Growing Shortage of Rheumatologists “Very Concerning”
Like this episode and want to here more? Check out our past episodes here!
Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com
Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)
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Washington's Influence on Patient Access
This episode delves into the intricate web of Washington's influence on patient access, exploring the multifaceted factors that shape healthcare legislation, policies and their impact on patients, other key stakeholders and drug pricing. With an insightful interview from one of Washington’s top healthcare experts, listeners gain insight to the complexities of legislation, such as the Affordable Care Act and Inflation Reduction Act. This is certainly the “wonkiest” podcast episode as we attempt to provide an understanding of the current landscape of patient access and look ahead to how Washington's decisions will shape the future of patient access.
Lance Grady, Executive Vice President, Avalere
Avalere
Cardinal Health.
Public Health Emergency (PHE)
AMP cap
The Affordable Care Act (ACA)
Innovation Center
The Inflation Reduction Act (IRA) CMS
Like this episode and want to here more? Check out our past episodes here!
Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com
Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)
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Tackling Copay Accumulators and Maximizers
In this podcast, we interview a consultant and a leading patient advocate to better understand and explore the challenges of copay accumulator and maximizer programs for specialty drugs. We discuss the difference between the two programs and their impact on the various stakeholders including the overwhelming burden placed on patients. We also discuss the legal issues and potential policy changes that could eliminate these programs or minimize their impact on patients. Ultimately, our goal is to shed light on this important issue and identify strategies for improving access to critical medications for patients who need them.
Carl Schmid, Executive Director, HIV And Hepatitis Policy Institute
Lauren Crawford Shaver, Senior Managing Director, FTI Consulting
HIV And Hepatitis Policy Institute
FTI Consulting
President's Advisory Council on HIV/AIDS
National Association of Insurance Commissioners.
Department of Health and Human Services (HHS)
What are co pay maximizers?
Like this episode and want to here more? Check out our past episodes here!
Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com
Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)
Customer Reviews
Excellent
Great postcard with clear and precise content. Definitely worth listening if you are interested in the complexity and challenges of the US patient access.
Excellent podcast
Knowledgeable hosts discussing some of the pre-eminent issues in healthcare today.