December 3, 2013

Copay Mechanisms: Which Card is Right for Your Product?

By Lash Group

While most brands know that providing copay assistance to financially challenged patients can be a key driver for product success, choosing the right copay mechanism for your needs can be difficult. Making the right choice requires being mindful of program goals, patient population and program processes. To determine which copay assistance mechanism is best for your program, evaluate the different card types below and learn how Lash Group, part of AmerisourceBergen, can help you customize your copay assistance program.

Underinsured Support

Traditional copay cards and programs are effective for underinsured patients. These cards often act as secondary or tertiary payments for medication and cover a portion of a patient’s out-of-pocket expense, which may vary depending on the level of coverage a manufacturer provides.

Our most flexible mechanism, the Lash Group FlexConnect card is a physical or virtual electronic benefit card that leverages seamless systems-integrated claims adjudication technology for providers, billing entities, retail or specialty pharmacies, or via online coupons and vouchers. FlexConnect harnesses the power of Lash Group technology while also ensuring that your program meets patients’ high-touch or high-automation needs. It is best suited for:

Access to specialty drugs
Seamless integration of services
Managing medical and pharmacy benefits
Leveraging eservices and scalable technology solutions
Inserting value into providers’ existing processes
Flexible program design

Debit cards

Co-pay cards that are either pre-loaded with a variable amount for use at a pharmacy or physician’s office or retroactively loaded following documentation review are also effective for covering the portion of the patient’s out-of-pocket expense that insurance will not cover. With debit cards, manufacturers can limit use to certain pharmacies or physicians.

The Lash Group FlexDebit card, our answer to the debit mechanism, is ideal when:

A provider base does not want to buy and bill for a product
A manufacturer wishes to provide patients with direct access to funds at the point of sale in a provider’s office

Starter cards

These types of cards allow patients to receive product at no cost for the initial fill. This approach is also ideal for giving patients access to a product while awaiting insurance coverage determination.

Designed for seamless access to the initial fill, our FlexStarter card can be used in combination with FlexConnect if manufacturers want to get patients on a drug quickly and then require business rules so that patients aren’t receiving entirely free copay assistance for the duration of their eligibility cycle. FlexConnect is best for:

Faster therapy initiation
Adjudication at the pharmacy
Offering multiple cards within a program
Programs that also verify financial need
Customizing the benefit at the program level

Combined copay mechanisms

A combination of one or more cards may be right for you if your patients’ needs vary and product access, adherence and ease of administration are all top priorities. Lash Group clients are not limited to one mechanism per co-pay program, though using more than one type of card may require benchmarking/exposure analysis to help understand your patients population. Our ability to combine mechanisms means Lash Group can support any type of card our clients want to run it in a single database to ensure all patient needs are met.

The Lash Group difference

With cards uniquely designed to work seamlessly with healthcare provider processes, the tailored Flex Copay program by Lash Group ensures appropriate assistance and expanded access for the underinsured. No matter which copay card you use, enrollment for patients is easy. From high-tech to high-touch, our enrollment capabilities include online activation, IVR, live agent and traditional methods. In addition, the outcomes information Lash Group provides for manufacturers on the back end gives you proof of program performance.

Topics:

Affordability