Fierce Healthcare on alternative funding for specialty drugs: patients bear the risks
Recent national poll findings by the PAN Foundation were featured in an article by Fierce Healthcare about alternative funding programs and their impact on patients.
“The for-profit vendors claim to help self-insured employers save money on specialty meds by obtaining them for free or at a steep discount through alternative sources,” writes Fierce Healthcare. “These include pharma patient assistance programs, charities or international sourcing. AFPs may advise employers to exclude some or all specialty meds from coverage. In cases where specialty drugs are covered, AFPs may offer services to obtain copay assistance. While their tactics vary, their goal is the same: Help employers reduce their pharmacy costs.”
Pharmacy benefit manager companies partner with alternative funding programs to appeal to small- and medium-sized self-funded employers. For these smaller plans, employers take on the costs of paying prescription benefit claims. While the employer saves money, and the PBM profits, some experts describe alternative funding programs as “sneaky, harmful to patients in a gray zone ethically and legally,” according to the article.
The PAN Foundation’s research found that third-party programs not only pass on the cost burden to patients, but they also create harmful delays (on average 68 days) to patients getting medication treatments.