19 MAY 2024insurers and pharmacy benefit managers implement more restrictive formularies or program requirements, leaving patients and providers to bear the financial, clinical and administrative burden.Specific changes this year have altered how we approach solutions to patient financial toxicity. The growth of copay maximizer plans, accumulator plans and alternative funding programs further complicates our work. Copay maximizer plans to adjust patient out-of-pocket costs, mitigating the benefits of coupons or assistance programs and exacerbating financial burdens. Accumulator plans restrict the use of manufacturer coupons or patient assistance programs towards patient deductibles or out-of-pocket expenses, often leading to surprise bills. Meanwhile, alternative funding programs misallocate manufacturer assistance program funding, leading to more restrictive guidelines and hindering financial relief for the most vulnerable populations.The growth of these programs has introduced new barriers to medication access, prompting our team to quickly adapt to stay ahead of emerging challenges. To navigate this terrain effectively, we must embrace a mindset open to new opportunities and solutions. Clear and concise communication is paramount, ensuring all involved are aligned and informed. Equally important is recognizing our constraints and strategically allocating resources to meet evolving needs. Specifically, our team at UNC is optimizing our objective data collection using questionnaires and other tools embedded in the electronic health record to identify opportunities to make us more effective and efficient. We are working closely with our clinical teams to make sure MAP services match their needs and enhance our collaborative relationship. We continue to leverage our external relationships with manufacturers, payors and colleagues to stay up to date on potential changes and best practices nationwide.True progress in expanded and simplified medication access necessitates larger-scale interventions, including legislative measures to better align the priorities of the payors, manufacturers, providers and pharmacies for the good of the patient. Until then, we remain committed to navigating these challenges and advocating for improved access to affordable, efficient healthcare. Our dedication to providing invaluable support underscores our commitment to support each patient we serve on their journey toward better health. IN AN IDEAL HEALTHCARE WORLD, MEDICATIONS WOULD BE PRESCRIBED, APPROVED, BILLED AND DISPENSED WITHOUT THE NEED FOR ADDITIONAL JUSTIFICATION OR FINANCIAL INTERVENTIONS
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