Payer Update, September 2023

Payer Update

In Good Times and in Trying Times
by Jeff Amond, Director Member & Community Relations

I was reminiscing a few weeks ago about my 6-year work anniversary with the Hemophilia Alliance and for whatever reason I started thinking about how my work on the Member and Community Relations Team was like a marriage. As odd as that statement sounds, it does make sense. We are here for HTCs in good times and in trying times. A real-life example of this is an HTC that I have been working with for the last 6 years. For much of that time, they were doing quite well. The HTC’s pharmacy had good market share and the larger hospital system had a good understanding of how the HTC and larger hospital system could be partner in the bleeding disorder space. Even though they didn’t need much assistance from me over the last 5 ½ years, I felt it was very important to develop and maintain a good working relationship with the HTC staff and larger hospital system. Our communications resulted in a good understanding of the services and support offered by the Hemophilia Alliance. Additionally, they developed trust in the Hemophilia Alliance as a member organization. This trust led them to reach out to us when Trying Times hit the HTC.

The Trying Times were directly related to the exclusive relationships that several of the major insurers in the area put in place with PBMs and Commercial Specialty Pharmacies that actively excluded HTC pharmacies from their networks. These exclusions drastically impacted the HTC’s pharmacy program’s market share. The HTC recognized that it needed additional help to stop this from continuing to occur. Currently, we are working with this HTC to enable them to provide pharmacy services to the patients that had to be dropped from the program, returning meaningful program income (over 3.5 million units of clotting factor along with over 20,000mgs of Hemlibra) to the HTC.

Please remember, The Hemophilia Alliance works for you in Good Times and in Trying Times. Please contact us to see how we can work together to grow your pharmacy program business and market share.

Also in this Issue…

Notes from Joe
· New Hemophilia Alliance President & CEO Search Update
· Partners Physician Academy – Second Annual Meeting held in Carmel Indiana on September 18, 2023

Advocacy Update
· What’s happening in Congress?

Notes from the Community
· Alliance Sponsors Reception for National Youth Leadership Institute (NYLI)

Alliance Update
· Did You Know…
· 2024 Meeting Schedules

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