Ali McBride offers suggestions and ways to help patients with out-of-pocket expenses.
I would say probably the first three, or the top three, are probably the same. Finance, finance, finance. A lot of our patients, due to the high cost of drug therapies, these patients often can't afford the high out‑of‑pocket expenses.
Working with different types of foundations to get therapies to patients, working with manufactured copay assistance. Even looking at state‑based foundations to provide access to patients is one of the key measures we do working with finance in a one‑on‑one fashion.
I think that probably continues to be one of the biggest issues whether it's an IV, or an oral‑based medication.
The second issue which really is a combination, or an issue where we constantly see this problem occur, it's compliance. We've been talking about this for many, many years, and I know it really has been extended in heart failure where these patients are on long‑term therapies for heart failure prevention, also management.
What we're seeing now is this going into the oral oncolytic field.
The situation has changed so because many of these therapies are costing 8 to 10 thousand dollars a month. For patients who are on insure, or actual payer to say, "Why don't we have a adherence measures from where the actual drug is being administered?" becomes an issue which needs to have warranted attention.
We're looking at these as well as another profile issue that can occur. The last one which may actually fall off the list going from the pharmacy‑based standpoint, but probably one of our pieces of bread of butter where we actually call it for pharmacist is the actual role of drug interactions.
Right now, there's a lot of drug interactions that can occur with food, with PPI inhibitors even looking at metabolic pathways, or inhibitory pathways which that drug is metabolized. These are issues that can occur very often, and when the patients actually have their medication list evaluated, they may not even be there.
We can do a very thorough job. We continue to do that to make sure these patients are on the correct medications, but also making sure we don't have those drug interaction risks which can lead to either a decreased outcome, or exposure to the drug therapy, or maybe higher risks of adverse events.