©2007 walgreen co. all rights reserved. 1 patient focused adap programs glen pietrandoni, r.ph...
Post on 28-Dec-2015
215 Views
Preview:
TRANSCRIPT
©2007 Walgreen Co. All rights reserved. 1
Patient Focused ADAP Programs Glen Pietrandoni, R.Ph
December 4, 2008
©2007 Walgreen Co. All rights reserved.
©2007 Walgreen Co. All rights reserved. 2
ADAP BenefitsADAP Benefits
Compassionate…Coordinated HIV CareCompassionate…Coordinated HIV Care
PhysiciansPhysicians Community/ASOsCommunity/ASOs
Retail Stores & Pharmacists
Public Health/Gov’tPublic Health/Gov’t
Medical Medical CentersCenters
PatientsPatients
©2007 Walgreen Co. All rights reserved. 3
Today’s Issues
• Many different ADAP models
• Access to services varies
• Providing drugs vs pharmaceutical care
• Public Health systems are complicated
• Quality of life issues
• Respect, privacy, cultural competency
• Changing health care models
• Reporting/Outcomes
©2007 Walgreen Co. All rights reserved. 4
HIV/AIDS in the U.S., 2009
• Growing number of people living with HIV/AIDS
• Changing the demographics:▪ Women and minorities▪ Younger and older▪ Rural
• More people on therapy▪ Treatment guidelines suggest starting drugs earlier▪ Drug therapy options increasing
• ADAP funding has been flat
• Human resources are exhausted
©2007 Walgreen Co. All rights reserved. 5
Estimated Prevalence Rates for Adults and Adolescents Living with HIV/AIDS
Total Rate=168.8*Rate (per 100,000 population) 2004—USA
<100 100 – 150 >150
Alaska 57.0
99.5
84.724.5
22.3 12.1 48.4
42.0
30.1
147.8
104.8
44.1
17.223.7
60.9139.5
196.0
88.0 74.4
99.7 50.9
66.7
166.3201.7
89.2 129.2 88.9
307.8
198.7
187.8116.9
103.068.0
72.970.4
42.5
145.668.1
44.243.2NH 48.7
MA 152.8
RI 126.9
CT 221.2
NJ 241.7
DE 234.9
MD 283.7
DC 1,960.0
Note: Data adjusted for reporting delays.
*Includes persons whose state of residence is unknown or missing.
Hawaii 120.9
Puerto Rico 324.3
127.5
43.7
©2007 Walgreen Co. All rights reserved. 6
HIV Communities:Population needs vary within a given state’s boundaries
•MSM
•Ethnic
•Women
•Religion/Churches
• IDU
•Sex workers
•Transgender
•Socioeconomic groups
©2007 Walgreen Co. All rights reserved. 7
HIV Payors
•Medicaid/Medicare▪ Medicaid▪ Managed Medicaid▪ Formularies▪ Rx limits
•Rx benefit▪ Employer plans▪ Mail benefits▪ Specialty Carve outs (United)▪ Major Medical
©2007 Walgreen Co. All rights reserved. 8
HIV Payors
•Ryan White Care Act▪ Title I▪ Title II
•ADAP (AIDS Drug Assistance Programs)▪ 340b closed network▪ Open network▪ SPAPs, Medicare wrap arounds, etc
•Local resources (county, city, charity)
•Compassionate Care Programs
©2007 Walgreen Co. All rights reserved. 9
Patient Choice Required
• Humanistic approached
• Respectful services
• Remove stigmas
• Convenience
• Quality of life improved
• HIV is a manageable health condition
©2007 Walgreen Co. All rights reserved. 10
Patient Centric Care• ADAP today in many states
▪ HIV drugs from one pharmacy▪ All other drugs from many different pharmacies
• What could be: All patient’s Rxs filled together ▪ Drug Interaction review ▪ Missing or duplicate therapies, regimen reviews▪ Adherence monitoring ▪ Monitor side effects▪ Better pharmaceutical care▪ Better clinical outcomes▪ Convenience▪ Face to face care if desired▪ Co morbidities evaluated
©2007 Walgreen Co. All rights reserved. 11
Patient Pickup or delivery
Patient Pickup or delivery
ADAP Administration and Pharmacy
Patient Rxs Patient Rxs
Example of many ADAP programs today
©2007 Walgreen Co. All rights reserved. 12
HIV Focused Pharmacies: Pros and Cons
Individualized service
Strong Physician communication
Specialized Inventory
Compassion
Educated staff
Provide delivery
Locations inconvenient to some
Limited hours of operation
©2007 Walgreen Co. All rights reserved. 14
Pickup anywhere or
delivered
Pickup anywhere or
deliveredData Check
& Drug ReviewData Check
& Drug Review
Clinical reviewClinical review
ADAP
Rx sent to pharmacy
via fax, phone, e-scribe
Rx sent to pharmacy
via fax, phone, e-scribe
Eligability Check & Formulary Review
Eligability Check & Formulary Review
©2007 Walgreen Co. All rights reserved. 16
NATIONAL HIVOPT-IN PROGRAM •Physicians•Patients•Nurses•Pharmacists•Patient Support Groups•AIDS service organizations•Church groups
top related