1. CONTROLLING THE COSTS OF HEMOPHILIA
HEMOPHILIA TREATMENT CENTERS:
CONTROLLING THE COSTS OF HEMOPHILIA
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2. INSERT YOUR HTC: WHO WE ARE
• One of 140 non-profit, federally recognized Hemophilia Treatment Center of Excellence
•HTC specialty pharmacy with access to the Public Health Service Federal Drug Discount Program registered with the OPA as a Hemophilia (HM) designated covered entity.
•Recognized best in-class care for the bleeding and clotting disorder community by NHF and the CDC.
•Comprehensive medical home to patients in (LOCATION) promoting collaboration across medical and pharmacy services.
•Stat delivery of on hand drug inventory reducing ER visits and time to treatment.
• Specialized in disease, utilization, and assay management.
• A Hemophilia Alliance Member sharing innovative ideas and best practices to promote cost effective high quality service to bleeding disorder patients.
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3. HEMOPHILIA: A RARE, EXPENSIVE DISORDER
The CDC estimates there to be 20,000 people living
with hemophilia in the United States.
Average cost of treatment for a person with severe hemophilia is approximately $300,000 per year and can surpass $1,000,000 if complications occur.
Hemophilia affects
1 in 5000 male births
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Sources: The Center for Disease Control and Prevention – http//
National Hemophilia Foundation –

4. THE HTC COMPREHENSIVE MODEL OF CARE
The National Hemophilia Foundation Medical and Scientific Advisory Council (MASAC) recognizes the HTC’s emphasis on early diagnosis and intervention as the optimal health care delivery model for this complex chronic disease.
CDC recognizes hemophilia as a complex disorder requiring good quality medical care from HTC doctors, nurses, social workers, physical therapists, and other health care professionals specialized in caring for people with bleeding disorders.
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*The National Hemophilia Foundation’s (NHF) Medical and
Scientific Advisory Council (MASAC) Standard

5. THE HTC COMPREHENSIVE MODEL OF CARE
REFERRAL
CLINICAL ASSESSMENT TEAM
INTERDISCIPLINARY CARE PLAN
IMPLEMENTATION / INTERVENTIONS
Assessment includes:
• Patient/Caregiver
• Physician
• Nurse
• Psychosocial Professional
• Physical Therapist
• Pharmacist
• Genetics Counselor
• Other HTC Team Members
Components include:
• Clinical Care
• Pharmacy
• Nursing Coordination of Care
• Psychosocial Support
• Physical Therapy Interventions
• Pain Management
• Clinical and Patient Goals
Coordination of Care:
• Medication/Supplies
• Lifestyle/Service Items
• Home Treatment Training
• School In-service
• Education & Support
• Adherence Monitoring
• In Home Coordination of Care
EVALUATION / REASSESSMENT / OUTCOMES
OUTCOMES ANALYSIS & REPORTING
Targeted education, adherence coaching, and side effect management improve clinical outcomes
Continuous monitoring of outcomes with goal of improving overall health. Ongoing communication between the HTC care team and patient is critical.
Desired vs. Actual
• Clinical
• Humanistic
• Economic
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6. COST MANAGEMENT
THE HTC COMMITMENT: Effectively manage the complications of hemophilia while monitoring adherence
to drug treatment and decreasing total cost of care.
-Hot Buttons
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7. CASE STUDY: COST SAVINGS ANALYSIS
Quoted charges obtained from insurance company as of April 10, 2014.
HTC provides clinical care to patient with hemophilia but patient’s insurance requires patient to utilize a national PBM or specialty pharmacy provider listed in their network to obtain drug.
Xyntha Solofuse:
30 day supply, total dose
ANNUAL SAVINGS
recognized by insurance company by contracting with HTC specialty pharmacy versus national PBM $193,668
$45,980
($1.51/unit)
$36,845
($1.21/unit)
$29,841
($0.98/unit)
NATIONAL
PBM
LOCAL
SPECIALTY
PHARMACY
HTC
SPECIALTY
PHARMACY
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8. CASE STUDY: INHIBITOR PATIENT
15-20% of all hemophilia patients will develop an inhibitor in their lifetime
Quoted charges obtained from PBM benefit notification to patient as of August 30, 2013.
HTC provides clinical care to patient with an inhibitor but patient’s employer requires patient to utilize a national PBM they have contracted with to obtain drug.
Novoseven:
Cost Per Dose
Hemofil M:
Cost Per Dose
$16,960
$11,600
$8,960
$6,960
NATIONAL
PBM
HTC SPECIALTY
PHARMACY
NATIONAL
PBM
HTC SPECIALTY
PHARMACY
SAVINGS recognized by employer
by contracting with HTC specialty pharmacy vs. National PBM:
8mg dose times 2, infused every two hours or 192mg per day
8,000 iu dose infused twice
daily or 16,000 iu per day
SAVINGS PER DAY:
$192,000
SAVINGS PER DAY:
$9,280
SAVINGS PER WEEK: $1,344,000
SAVINGS PER MONTH: $278,400
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9. CASE STUDY: COST SAVINGS THROUGH ASSAY MANAGEMENT
Service Provider
Disease Severity
Average IU/Kg/Year
No. of Patients
Avg. of Units Dispensed
Avg. Cost per Unit
HTC
Severe
4,448
125
300,553
$0.98
Commercial Specialty Pharmacies and PBMs
5,395 31
352,716
$1.21
Data collected reflects the additional cost savings per patient when utilizing the HTC specialty pharmacy.
PER PATIENT ANNUAL SAVINGS:
Average decrease in units dispensed: $63,117.23
Ask about this
• All patients included in the comparison receive clinical care through HTC.
• Patients with inhibitors are excluded from this study.
• Commercial pharmacies include 9 entities including Accredo and Caremark.
Average commercial cost per unit of product is $1.21 and 340B cost per unit of product based on the federal discount is $0.98. Actual savings will vary based on cost and insurance reimbursement.
Average per unit cost reduction: $69,127.19
TOTAL AVERAGE SAVINGS: $132,244.42
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10. LET’S WORK TOGETHER. YOU see a direct impact to your bottom line.
PATIENTS receive the best
possible care and an
enhanced quality of life.
YOU see a direct impact
to your bottom line.
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11. THANK YOU FOR YOUR TIME.
QUESTIONS?
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