Why TheraCom

Success Stories

A manufacturer of a medical device had reimbursement support with another vendor, and had been informed that the product was always covered under the medical benefit, requiring physician “buy and bill.” Benefit investigations were not timely, resulting in lagging product sales.

TheraCom offered a comprehensive, consolidated service offering to include a centralized point of entry or hub, reimbursement support, including online pharmacy benefit verification, and medical benefit verification.

Benefit verification identified that at that time, approximately 20-25% of cases had coverage through the prescription benefit. This typically resulted in lower out-of-pocket costs to the patient and a reduction in physician “buy and bill.” Since that time, sales have grown dramatically, outpacing manufacturer expectations on a month-by-month basis. Demonstrated product coverage has eased concerns for risk-averse prescribers, and the streamlined product access program has contributed to significant market success.

A manufacturer of two self-injectable products required reimbursement support as many health plans subjected the products to arduous prior authorization processes that provided obstacles to patient access.

TheraCom worked collaboratively with the manufacturer to define and implement a Prior Authorization Assistance program to include completion of prior authorization forms on behalf of the provider’s office and submission directly to health plans.

The Prior Authorization Assistance Program eliminated administrative burden on prescriber office staff, resulting in a documented decrease in issues regarding physician acceptance of the products.

A manufacturer of a self-injectible therapy experienced challenges with patients’ maintaining compliance with therapy due to a challenging therapeutic course and challenging side-effect profile.

Average length of therapy studies conducted pre- and post-implementation demonstrated that patients participating in the clinical support program stayed on the product 48% longer than those not participating in the program.

A manufacturer of a self-injectible therapy identified a significant drop-off of patients due to issues with side-effects.

TheraCom worked closely with the manufacturer to create an enhanced side-effect management program for the existing nursing support line. TheraCom also revised patient support materials to highlight the nursing support line and raise awareness of the services available to the patient.

After-hour call volume increased by 300%, with the highest call volume occurring on the night of the injection. Evaluation of real-time data enabled the manufacturer to identify this trend and take action in real-time, with immediate results.

A manufacturer of a self-injectable therapy experienced challenges with patients’ commitment to therapy. The treating physicians did not have the resources to provide in-depth training and support in the office.

TheraCom co-developed and implemented community-based, product-specific training classes for patients and their families to encourage compliance. TheraCom also established training sites, developed training materials and trained instructors to conduct classes.

Program was widely successful in cooperation with manufacturer sales force, exceeding 90% satisfaction rate and achievement of program goals.