Pharmspective's Market Access Tool: PolicyViewTM




An explosion of specialty drug approvals has resulted in a dearth of medical policies outlining utilization criteria for novel therapeutics. This has led to a dramatic increase in the number of prior authorization reviews required to dispense specialty drugs and greater complexity in fulfilling Rx requests.
 
This new landscape has provoked concern among specialty pharmacy providers about how to stay on top of evolving payer policies and how to help customers secure approval and reimbursement. With so many nuances across payers' policies for similar therapies, specialty pharmacy is often a last recourse for providers and patients seeking to avoid hurdles in gaining approval for biologics and other specialty drugs.
 
Without a standard for capturing the core aspects of medical policies that matter most in gaining approval, explaining differences between payer policies is challenging. Providers are faced with a myriad of existing payers, and simplifying the understanding of authorization criteria for all stakeholders is a priority, especially as it relates to complex therapies with restricted uses.
 
The rapid and widespread adoption of tablet technology for information management has created a new opportunity to leverage these tools to simplify the acquisition and interpretation of data contained in medical policies. Pharmspective’s PolicyViewTM, available in PC and iPad versions, adheres to the principle of making sure the user is no more than 3 keystrokes away from the information that is needed. PolicyViewTM synthesizes the core components of medical reimbursement policies for specific therapies in an easy-to-view format that invites comparisons. With policies for 44 leading payers, users can easily access key criteria for authorization and utilization of therapies in rheumatoid arthritis, psoriasis, multiple sclerosis, Crohn’s disease/ulcerative colitis, lupus, and leading oncologic conditions (breast cancer, colorectal cancer, prostate cancer, lung cancer and melanoma). The tool also includes vital links to drug compendia.
PolicyView
 
Downloadable prior-authorization forms are readily available; with PolicyViewTM, users will no longer have to waste time scouring the Internet for important documents.
 
Evolving the aggregation of information management to keep pace with the dramatic increase in novel therapies is a critical challenge facing specialty pharmacy. The need for collaborative efforts across the specialty pharmacy community to create standards for information and education about medical authorization criteria will be an ongoing challenge.

If you want to collaborate on data applications related to medical policies or learn more about Pharmspective’s PolicyViewTM application, please contact Cindy Wong at cindy.wong@pharmspective.com.

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