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Prescription Assistance Program (PAP)

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

margaret-johnston
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Prescription Assistance Program (PAP)

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  1. Prescription Assistance Program (PAP) Mission “Aiding individuals in obtaining needed medication for maintaining and improving healthy lives.”

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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)

  7. Services Provided Cont. Health Insurance Counseling (Certified through North DakotaInsurance Department) Outreach (Service information to health care and human service providers and responsible prescription use information to clients. Presentations to electronic newsletters.)

  8. 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

  9. 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)

  10. PAP Organization Program Director (1) Part-Time Staff / Technicians (3) Contributors: Courier systems between offices and providers and provider enrollment / credentialing services

  11. 2010 Annual Snapshot 262 Health Care Providers Served 465 Clients Served 2,727 Medications Processed $4,892,040 Prescription Savings Obtained

  12. Top Medications Obtained 2010 Medication Cost Use ____________ Glucose Test Strips $839,640.90 Diabetic Testing SupplyNovoLog $538,877.36 Rapid-Acting InsulinLantus $290,596.95 Long-Acting InsulinHumira $164,588.40 Arthritic Anti-InflammatorySymbicort $109, 591.70 Respiratory SteroidHumalog $102,093.90 Rapid-Acting InsulinLamictal $100,171.30 AnticonvulsantAdvair Diskus $90,806.47 Respiratory Inhalation Neurontin $85,650.30 Anticonvulsant Abilify $75,015.90 Anti-Psychotic / Dementia

  13. 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

  14. 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

  15. 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)

  16. Questions For further questions please contact: Ty Hegland Director / Public Affairs Officer(701) 364-0398 ty@southcentralseniors.org

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