Payer Update, November 2023

Member and Community Relations Update

From Frustration to Opportunity – Maximizing HANS as a Resource
by Jeff Amond, Director Member & Community Relations

Over the last few weeks, I attended two Regional Meetings. One big take home message from many of the attendees was the continued frustration of losing HTC pharmacy patients to commercial specialty pharmacies. As we know, this frustration has been going on for many years. In 2018, I wrote a newsletter article about the frustration I personally had when I worked at my old HTC because I just didn’t have the time nor the resources to take on that fight of trying to get the lost patients back to our pharmacy program. In 2020, I wrote another newsletter article about HTCs that were feeling overwhelmed and frustrated with the struggles to keep their patients under their pharmacy program.

In 2023 the frustration continues, but we are better able to combat the problem through new opportunities made available by the Hemophilia Alliance Network Services (HANS). Below is a summary of the results of bringing business back to HTC pharmacy programs since 2018, along with the potential new units from our current opportunities. We have brought back over 45,000,000 units to our member HTC pharmacies over the last five (5) years and our member HTCs have been able to retain these units in their pharmacy programs.

2023 New Units 3,020,280
2022 New Units continued in 2023 2,469,880
2021 New Units continued in 2022 3,528,400
2020 New Units continued in 2021, 2022 & 2023 5,175,000
2019 New Units continued in 2020, 2021, 2022 & 2023 10,450,000
2018 New Units continued in 2019, 2020, 2021, 2022 & 2023 21,060,000
Total New Units 45,703,560
Potential New Units – Current Opportunities 87,367,754

These results are an example of our success, but we can do so much more with your help and participation in our HANS PPO network. New opportunities present weekly/monthly to bring patients back to your HTC for clotting factor dispensations. HANS participation facilitates quick turnaround of these opportunities to ensure we do not lose patients. Importantly, HANS is closing in on formal agreements for inclusion of Gene Therapy products with several major entities that will pave the way for your HTC to be paid for these high-cost products when you are ready to provide them to your patients. The conversations the HANS Team has with insurers about Gene Therapy have also opened new doors for participation in networks for traditional clotting factor where HTCs have historically had difficulty dispensing products to patients within their care.

If you have been waiting for a reason to join HANS, now is a great time to start that process. Discussions with insurers and employers on Gene Therapy solutions and traditional products are increasing rapidly. The Hemophilia Alliance team would like you to be prepared to take advantage of these new opportunities as they emerge. Let us help with your insurance issues, let us help you in retaining your current pharmacy patients, let us help you with Gene Therapy solutions and agreements, and let us help you win back the clotting factor business to your HTC. WE WORK FOR YOU!

Also in this Issue…

Notes from Joe

Legal Update
· Genesis Healthcare Inc. v. Becerra: District Court Invalidates HRSA’s Patient Definition and Implementation in 340B Program

Advocacy Update
· 2025 NBPP Proposed Rule Released with Positive Policies for Bleeding Disorders Community

Alliance Update
· Hemophilia Alliance Resources Available to Members
· 2024 Meeting Schedules

Notes from the Community
· 2023 Unite Walk Wall of Walkers update

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