Hemophilia & HAE Management Service
Problem
Out of the $3.5 trillion spent on healthcare, it is estimated that 25% is attributed to waste. With rare diseases like hemophilia and HAE, that number adds up quickly - representing up to a $1.5 billion opportunity for healthcare payers in the US.
This opportunity cannot be realized by monitoring claims data alone, high quality clinical data is necessary to add context and see the complete picture.
Medication is OVER-DISPENSED
- Extra on-demand doses are shipped liberally at an average of 4 extra doses per patient per year
- 25-50% of pharmacy shipments fall outside of contractual parameters
- Pharmacies are incentivized to dispense due to a limited risk of audit
Solution
Audaire Health’s HIPAA compliant web platform provides the payer with 100% transparency on physician, pharmacy and patient performance.
The platform provides payers with unprecedented visibility into the hemophilia & HAE benefits. By combining physician and pharmacy performance data with patient utilization data, you can pinpoint areas for improvement to easily contain costs.
Payers can contain costs through validation of:
- Physicians - dosing medications appropriately (strength, frequency, standard vs. extended half-life)
- Pharmacies - dispensing factor according to contracted stipulations
- Pharmacies - not drop shipping or overshipping on-demand doses
- Patients - utilizing medications appropriately
Real-life Audaire Health Hemophilia Example
60 KG patient on Kovaltry, 3000 IU QOD:
- Pharmacy shipped 20 doses per month x four months
- Patient reported ZERO on-demand doses needed!
- After intervention, pharmacy shipped 15 doses per month
- Twelve month savings = $382k
Audaire Health has found that 50% of hemophilia factor patients have dosing and dispensing anomalies. This equates to an extra cost of $43,600 per patient.
What could your savings be?