Benefit Plan Design Approaches

Hemophilia and Bleeding Disorders Toolkit

Necessary hemophilia-related costs usually can’t be reduced, but unnecessary costs can be avoided, and cost trends contained. However, standard methods and strategies offered by health plans and PBMs such as exclusive networks and preferred drug lists can contribute to unnecessary hemophilia-related costs. This is mainly due to the time it can take for a drug to reach a patient. In most cases, a patient with hemophilia needs to receive treatment in a timely and precise manner – often requiring same-day turnaround. With exclusive networks and preferred drug lists, medication may be delayed reaching the patient. The drug may need to be shipped from another state and if prior authorization is not well managed, there can be additional delays getting treatment to patients quickly. These delays can create adverse health events with related treatment needs.

It’s important to understand your current benefit design and how it relates to hemophilia. Removing barriers and obstacles in the path of optimal hemophilia treatment will ultimately lead to better patient outcomes and avoidance of unnecessary costs for employers.

Using Plan Design to Improve Outcomes

Carve Out & Contract Standardization

Patient Financial Assistance