Set to begin radiation therapy the next day, the patient was anxious. Not just about her thoracic cancer treatment, but also about the oral chemotherapy she took at home. It came with high insurance copays.
Then came a phone call that eased her concerns. As they had earlier in her treatment, members of Dana-Farber’s Specialty Pharmacy team worked together to secure outside grants to cover the oral chemotherapy copays. The patient would owe nothing.
“I can sleep better tonight and go into radiation feeling relieved that I can still get this medication that is saving my life,” she told the pharmacy resource specialist who delivered the good news to her. Later, in an email, the patient praised the two pharmacy staff members who helped her as “wonderful examples of the kindness and professionalism that are so important to patients like me going through a difficult time.”
With the growing use of oral chemotherapy, Dana-Farber launched a program in 2019 to deal specifically with specialty medications — primarily self-administered medications like oral chemo. Generally requiring more attention by patients to be successful, specialty medications can be more expensive and usually require prior approval from an insurance company. They are not available from most local retail pharmacies and need to be taken carefully to ensure their safety and effectiveness.
Dana-Farber pharmacy staff members work directly with patients to make sure they know how to take these uncommon drugs safely, including education on how to take each drug, a review of possible side effects, confirming the patient’s clinical condition, and periodic check-ins. A licensed Dana-Farber pharmacist is available for specialty medication consults 24 hours a day, every day.
The Specialty Pharmacy team also helps secure insurance company approvals and suggest resources for assistance with copays and related costs. The team’s pharmacy resource specialists are automatically alerted when patients are prescribed specialty medications with high copays – and one of them will start looking for financial assistance on behalf of the patient through grants from outside organizations such as the Leukemia and Lymphoma Society. Meanwhile, a pharmacy benefits specialist works to get any prior authorization needed for the medication by the patient’s insurance company.
“One of our greatest strengths is our people, who are very passionate about helping our patients,” says Jason Poquette, RPh, specialty pharmacy director at Dana-Farber. “Our team members are all assigned to specific areas at Dana-Farber, so they become familiar with those patients and clinicians. In most cases, patients interact each time with the same person from each of our teams.”
Patient care coordinator Phaula Yun says this sense of continuity is greatly appreciated by patients.
“A lot of pharmacies will have patients call to schedule their refills every month, but I reach out to them personally, usually a week before they run out, to coordinate the delivery,” says Yun. “I am also the first point of contact for my patients. If they have any kind of problem other than benefits issues, they know they can contact me. For benefits, they know they can work with my colleague.”
In patient surveys, reviews for the specialty pharmacy program have been overwhelmingly positive. “You guys always have the answers to all my questions,” one patient wrote.
If you are a Dana-Farber patient, learn more about ordering specialty medications by phone or online.
Way to go Phaula Yun – Reducing finacial toxicity and improving patient outcomes!