You may already be aware that patient support programs (PSPs) are services funded by pharmaceutical manufacturers that provide support for you and your patients who are prescribed specialty medications requiring prior authorization. They can help you and your patients navigate the complexities of prior authorization claims submission and reimbursement.
PSPs may also have funds available to them through a patient assistance program to help with the cost of your patient’s medication if they do not have coverage elsewhere or if the drug prescribed is not covered either publicly through a special access program or privately through a group benefit plan.
There are many patients support programs (PSPs) available. The PSP that can help you and your patient through the specialty drug prior authorization claims process will be specific to the drug(s) you have prescribed and the condition the drug has been prescribed to treat.
Most PSPs are not accessible to patients without physician involvement. If you do not know which PSP can provide you and your patient with assistance, contact can be made with the drug manufacturer for the product you are prescribing to ask them if a PSP is available to your patient. Drug Access Canada is a website which provides healthcare professionals with information on PSPs. You can also find out more about key PSP providers under our Resources tab.
If you are an oncologist, then your patient can be referred to the individual(s) acting as drug access navigators (DANs) working in your hospital. They will work with you and your patient to investigate access requirements for the drugs you have prescribed, both public and private payers, and they will know how to enrol your patient in a PSP.
The Simplify Prior Authorization initiative is an advocate for education about prior authorization (PA) and improvement in current prior authorization practices and processes. If your organization is interested in finding out more, getting involved, or in sponsorship of this important initiative, please contact us via the link below.