Pharmacy Assistance Programs

MAP and RxAP

 

Applying for prescription assistance programs can be complicated and time consuming for patients due to varying qualifications, criteria, and processes with each pharmaceutical company.

UniNet chapters in Kearney and Omaha offer a prescription assistance program to help physicians and their patients navigate the pharmaceutical company application process for many brand-name medications. These programs are called Medication Access Program (MAP) in Kearney and Prescription Assistance Program (RxAP) in Omaha. 

RxAP/MAP Services can include:

  • Determine which pharmaceutical assistance programs a patient may qualify for, based on medication, income, and insurance status. RxAP works with approximately 15 different pharmaceutical company prescription assistance programs.
  • Help patients through the initial application, re-enrollment, and refill processes.
  • File appeals and research other sources of prescription support for those individuals with extensive medication needs that are not eligible for the traditional Patient Assistance programs. 

RxAP does not qualify or approve patients for any financial assistance or make clinical judgments. However, a referral will be made to the UniNet Medication Therapy Management program to review a patient’s medications and determine a prescription that may be affordable long term or that could be changed if needed.

In Kearney, the Medication Access Program helps fill 4,000 to 5,000 prescriptions for approximately 1,500 to 2,000 patients in a typical year. From July 1, 2003 to June 30, 2014, MAP provided more than 60,000 prescriptions with a total prescription cost of $26.3 million dollars.  The average annual savings for patients in the Kearney community is $2.39 million per year. 

In Omaha, RxAP has served 360 patients and assisted with 1,189 applications since October 2013. The average wholesale price of the medications resulting from these applications is approximately $1,189,000.

UniNet Kearney and Omaha providers and/or population health coaches can refer patients to the program.

  

Medication Therapy Management

 

UniNet’s Medication Therapy Management (MTM) program helps patients get the best benefits from their medications by actively managing medication therapy and by identifying, preventing, and resolving medication-related problems. The program helps patients understand their medications, and optimize patient adherence to their prescription regimen to help achieve better outcomes. 

Patients referred to the MTM program through a UniNet-affiliated provider, UniNet population health coach, or hospital discharge planner can be counseled on:

  • Medication affordability: If cost is prohibiting a patient from taking their prescription, the MTM staff will analyze the medication to ensure it’s the best option, determine the patient’s insurance coverage, identify if they may qualify for other coverage options (ex. Medicare Extra Help, Medicaid), and research generic options or a more affordable pharmacy. The MTM staff follows evidence-based guidelines when recommending alternative medication options to the patient’s provider. 
  • Medication instruction: Patients can receive tips on ways to keep their medications straight, and how to take them properly. If a patient isn’t taking their prescription, MTM staff will work with the patient to help determine the cause for non-adherence and offer solutions.
  • Potential drug interactions and medication-related side effects: For a patient with multiple prescriptions, MTM staff will review the list of medications, determine if they are up to date, look for potential interactions, and find out if the patient is experiencing any side effects.
  • Medication reconciliation: For patients on several medications and/or seeing several different providers and specialists, MTM staff will update the patient’s record with current medications.

Insurance research regarding medications is part of the MTM program. MTM staff does not do routine prior authorization verification, but will investigate why a patient needs a prior authorization for a medication or provide other potential medication options.

The MTM program is managed by UniNet Pharmacist Specialist Laurie Hayes, Pharm. D., and is collaboration between UniNet and the Creighton University School of Pharmacy and Health Professions.  UniNet often has a fourth year pharmacy student on the MTM rotation. The MTM program was started in March 2013. Since January 1, 2015, MTM staff has worked with about 75 patients. 

Patients can access the program through a referral from their UniNet provider’s office.