Patient Assistance Programs (PAP)
Carve out 100% of your member’s drug cost off your plan sponsor’s traditional benefit without disruption. Our PAP program is the solution for your members who truly need financial assistance in paying for their medication.
Making a Difference One Client at a Time
Alternate funding solutions using Patient Assistance Programs are not universal, it requires experience and a comprehensive clinical strategy that benefits both the health plan and the member.
Boost your cost-containment strategy with our member-centric solution, built to scale for our broker, consultant, TPA, PBMs, and health plan community to meet their specific needs.
One of our recent clients received a 21% drug cost reduction off a 3-million-dollar annual plan spent using our program.
Your Challenge
High-cost specialty and non-specialty medications impact both medical and pharmacy benefits. Balancing your member's healthcare needs when they truly need it the most and paying for it is a challenge plan sponsors face every day. Nearly 50% of drug costs - $500 billion - are projected to be designated as specialty. Despite this growth trend, many individuals simply can't afford these prescribed medications. We can help.
Our Solution
While other Patient Assistance Programs focus only on specific drugs, our comprehensive strategy allows us to generate savings for specialty and non-specialty drugs.
Our program helps eligible individuals qualify for manufacturer drug savings programs on high-cost medications, improves medication adherence, and potentially reduces prescription drug and medical costs by up to 60%. Our Patient Assistance Program offers:
- Overlay on current plan benefits.
- No Changes to
- Formulary
- Clinical programs (step therapy, prior authorizations, high dollar edits)
- Specialty coverage
- PAP coverage is for covered drugs.
- Allows member access to medication during the PAP eligibility process.
Why Choose Us?
Member-Centric Clinical Approach
Our extensive approach works cross-functionally to achieve savings and fulfillment for all those involved, making other Patient Assistance Programs unable to compete. Our process improves stop-loss carrier loss ratios, and client retention, and reduces the need for lasers and/or significant premium increases. The member experience is ideal because:
-
No drug access barriers to needed therapies – Day 1 medication access.
-
We educate and assist the member in the PAP process.
-
Work with the member’s Provider and Drug Manufacturer to secure PAP eligibility.
-
Monitor the member’s PAP drug supply.
-
Repeat member advocacy year over year for PAP renewals.
Savings for All Plan Sizes
Leverage Our Expertise Today!
Transform your benefits strategy. Empower your clients. Amplify your results. Discover tailored solutions for Brokers and TPAs in the self-funded arena.
Amwins Health & Employee Benefits Consulting has the solutions to help you gain and retain clients.
