Hepatitis C is often called a silent disease. Those infected can go with little to no symptoms for months or even years before they have any indication that something might be wrong. While they are unaware, the disease is attacking the liver. Hep C can lead to serious conditions such as liver cirrhosis and is the leading cause of liver cancer and the need for transplants.
In the United States, the rate of new cases of Hep C has nearly tripled since 2010. Since 2014 the estimated number of cases in the country has increased from 2.7 million to 3.5 million, and while disease was once most prevalent among baby boomers, the US is seeing an increasing number of cases of young people affected.
Until recently, patients shocked with this diagnosis had little hope. They could take a course of injections and pills that lasted for months, endure harsh side effects like depression, anemia, and flu-like symptoms, and still have less than a 50% chance of being cured.
This was not the case for one young woman in Arizona, because in the last few years alone the outlook for Hep C has changed drastically. New drugs are all oral, have few and mild side effects, and can completely cure up to 98% of the patients who take them in 12-24 weeks. This patient was tentatively cured within the minimum 12.
The problem in achieving that end to the story for this patient and others like her? The price tag. Most of these treatments are once-a-day pills that can cost up to $1,000 per dose. For the patient it can mean a burden upwards of $80,000 - $200,000 on them and/or their insurance, depending on the drug needed and the time it takes to be cured.
For independent pharmacies, this is only the beginning of problems. If they are certified as a specialty pharmacy, the inventory cost alone can be overwhelming to most independents. If they are not a specialty pharmacy, they are forced to refer their patients elsewhere for these specialty drugs and risk losing them altogether. With rapidly growing demand for Hep C drugs, this is a real problem for these small businesses.
For patients, the cost means many insurers restrict access to the drugs to only the sickest patients, and/or apply other strict criteria to determine who will have treatment paid for. Many patients are rejected for coverage, and even a large number of those who are eventually approved must first fight through a lengthy, repeated appeals process. Such was the case for the patient in Arizona, who was finally able to receive the treatment she needed through a local pharmacy once she was, eventually, approved.
How was her local AAP pharmacy able to help her in the end? Because they had partnered with AllyScripts.
AllyScripts is a full-service specialty pharmacy, designed to partner with AAP member pharmacies to help them retain their specialty patients and streamline specialty service. AllyScripts takes on the inventory cost of expensive drugs like Hep C treatments and cancer medications, among others, and provides other services like Pre-Authorization, patient intake, and refill management as well as required clinical and outcomes monitoring. Where possible, AllyScripts will ship to the participating pharmacy to allow the local store to maintain a face-to-face relationship with their patients.