Transcript Presentation - South Central Adult Services

Prescription Assistance
Program (PAP)
Mission
“Aiding individuals in obtaining needed
medication for maintaining and
improving healthy lives.”
History of PAP
- Established in 2003 as a collaborative effort between
SCASC, Dakota Medical Foundation and regional
health care providers
- Piloted in Valley City and furthered developed with an
office in Fargo
- Currently serving clients and health care providers
in ND, MN, SD and four additional states
Need for PAP
- Address the barriers disadvantaged
individuals face when attempting to
access needed medication:
Low-income, lack health insurance, lack prescription coverage
and seniors in the Medicare Part D Coverage Gap
- Reduce operating costs for health care
providers in relation to prescription
assistance processing
Statistical Need
Assessments conducted with Dakota Medical Foundation:
11.2
Average hours of service
per PAP client annually
56%
Average savings per client PAP
provides on operating costs to providers
Average Client
-
Lacks major form of health insurance
-
Below 250% of Federal Poverty Level
-
Seeks assistance for 5+ medications
-
Receives $10,500+ prescription savings
annually
Services Provided
Prescription Assistance Processing
(Five-step process including initial referral,
coordination between client and health care
provider and submission of materials
to pharmaceutical manufacturers)
Case-Management
(Average client receives three
refills per medication annually)
Services Provided Cont.
Health Insurance Counseling
(Certified through North Dakota
Insurance Department)
Outreach
(Service information to health care and human
service providers and responsible
prescription use information to clients.
Presentations to electronic newsletters.)
How Prescription
Assistance Works
Initiated by referral from health care provider,
human service organization or self-initiated
Continues with five step processing consisting of
coordination between patient, health care provider,
and pharmaceutical manufacturer
Ends with individual receiving 90-day supply of
medication (mailed to home or doctors office) and
being eligible for three refills per medication annually
How $$$ Is Saved
Patients
(Savings on prescription medication and office visit co-pays)
Providers
(Savings on operating costs)
Manufacturers
(Tax incentive to provide medications to 501(c)3 programs
and low income individuals)
PAP Organization
Program Director (1)
Part-Time Staff / Technicians (3)
Contributors:
Courier systems between offices and providers
and provider enrollment / credentialing services
2010 Annual Snapshot
262
Health Care Providers Served
465
Clients Served
2,727
Medications Processed
$4,892,040
Prescription Savings Obtained
Top Medications
Obtained 2010
Medication
Cost
Use
____________
Glucose Test Strips
NovoLog
Lantus
Humira
Symbicort
Humalog
Lamictal
Advair Diskus
Neurontin
Abilify
$839,640.90
$538,877.36
$290,596.95
$164,588.40
$109, 591.70
$102,093.90
$100,171.30
$90,806.47
$85,650.30
$75,015.90
Diabetic Testing Supply
Rapid-Acting Insulin
Long-Acting Insulin
Arthritic Anti-Inflammatory
Respiratory Steroid
Rapid-Acting Insulin
Anticonvulsant
Respiratory Inhalation
Anticonvulsant
Anti-Psychotic / Dementia
Provider Assessment
Results
100%
Believe the patients they refer are able to
maintain or improve their overall health
100%
Save operating time and costs due to being
able to refer clients to PAP
Client Assessment
Results
100%
Believe they are able to maintain or improve overall
health due to access to PAP services
98%
Of individuals who lack basic health insurance benefit
by being able to access PAP services
60%
Do not engage in lifestyle activities that are
detrimental to their prescription use
Strategic Plan 2011
1. Expansion of services and service area
(Balance rural and urban needs)
2. Development of acute medication voucher
(Reduce systemic costs if left untreated)
3. Development of “Fill The Pill” fundraising drive
(Diversification)
4. Development of “Responsible Patient Initiative”
User Manual
(Further develop overall mission of PAP)
Questions
For further questions please contact:
Ty Hegland
Director / Public Affairs Officer
(701) 364-0398
[email protected]