Community health centers are the backbone of health care for underserved and vulnerable populations in the United States, with more than 30 million Americans in over 13,000 communities leveraging these facilities to receive affordable and accessible treatment they might otherwise go without. The 340B Drug Pricing Program is a crucial source of support for covered entities, allowing these safety net-providers to stretch scarce federal resources and reinvest them in patient care.
However, on the tailwind of a multiyear global pandemic and changes to 340B drug manufacturer reimbursement, many covered entities have found themselves struggling to sustain and build their patient bases with the limited resources they have available.
“A 340B program can be a great financial asset for a non-profit,” says Ben Walker, Director of Clinical Services at ASHwell (an Avita covered entity partner). “It can help you do a bunch of different new things for your patients, but it all depends on growing and sustaining your patient population. We need to be able to retain our patient base, and our patients need to be able to access their medications for our 340B operation to work.”
Avita’s SVP of Patient & Community Advocacy, Glen Pietrandoni, as well as Avita Pharmacist-in-Charge Andy Doan chatted with Ben in a recent webinar titled “How to Build Your Patient Base with Limited Resources.” On the agenda? How to effectively market to patients with a limited budget, whether thoughtfully widening your service model helps attract new clients, and why partnering with a pharmacy services provider and/or opening an onsite pharmacy makes sense. If you missed the webinar, don’t sweat it! Simply click here to watch the recording. Looking for a quick recap? Check out the highlights below.
A 340B program can be a great financial asset for a non-profit. It can help you do a bunch of new and different things for your patients. But it all depends on growing and sustaining your patient population.
On why growing your patient base is critical to sustaining your mission:
“A 340B program can be a great financial asset for a non-profit. It can help you do a bunch of new and different things for your patients. But it all depends on growing and sustaining your patient population. We need to be able to retain our patient base, and our patients need to be able to access their medications for our 340B operation to work.”
-Ben Walker
Director of Client Services, ASHwell
On engaging the community by offering expanded services:
“ASHwell was founded in 1988 as an AIDS Service Organization (ASO) focused on serving people who were dying, and assisting their families and friends. After protease inhibitors became more widely available in the 90s, we saw the first major decrease in deaths with AIDS. Our organization’s focus then shifted to community HIV testing and case management for people living with HIV.
We rebranded ASHwell in 2018 and launched our clinic the same year. Since then, we’ve grown from a staff of eight to approximately 35 full-time employees. We serve over a thousand patients a year in the clinic. We also have a peer support program, and a case management program. We’ve seen a huge response to the messaging we’ve put out, starting with status neutral care, but growing to include sex positivity, pleasure positivity, lifestyle, and gender affirmative care.”
-Ben Walker
Director of Client Services, ASHwell
Patient fulfillment is a long process that's not glamorous by any means. And even one problem will stop it dead in its tracks.
On the importance of listening to patients when considering new services:
“We chose our expansion [strategy] by listening to our patients. They told us what they needed, and then we tried to match that up with what was in line with the mission of our organization.”
-Ben Walker
Director of Client Services, ASHwell
On going where the patients are:
“Going out there in the community and leveraging our community partners has been super important. It’s allowed us to expand the services that we provide as well. We’ve set up pop-up clinics in the community. We’re out in local bars; we go out with a provider, a nurse, a phlebotomist, and a pharmacist. Being in the community spaces where our patients come from, whether it’s clubs, bars, or events, has reinforced that ASHwell is there for and because of our patients, and that we’re authentically connecting with them.”
-Ben Walker
Director of Client Services, ASHwell
We chose our expansion [strategy] by listening to our patients. They told us what they needed, and then we tried to match that up with what was in line with the mission of our organization.
On the pharmacy team's role in patient fulfillment:
“Patient fulfillment is a long process that’s not glamorous by any means. And even one problem will stop it dead in its tracks. So even though on the outpatient side we’re always worried about clinical implications like modifying therapy interaction and side effects, the dispensing side is just as important in making sure that the medication gets into the patient’s hands—which is essentially fulfilling the mission of our partners and optimizing adherence.
As a pharmacy that specializes in HIV, PrEP, HCV, sexual wellness, and LGBTQ+ care, Avita brings something unique to the table: The majority of our pharmacists are accredited with the American Academy of HIV Medicine. Because of that, we truly understand the clinical and emotional intricacies that come with these patients.”
-Andy Doan, PharmD, AAHIVP
Pharmacist-in-Charge at the Avita onsite pharmacy at ASHwell
On the benefit to patients of having an onsite pharmacy partner:
“Having a pharmacy onsite gives the pharmacy team the ability to fully troubleshoot any issues with coverage and providers for our patients. Because of that, we have the unique opportunity to create solutions that would be a lot more difficult or unfeasible if the prescription was filled with an external entity.
There are other barriers to patient access that the pharmacy may find through our constant communication with the patient. Things like patients having lost insurance coverage, or needing special accommodations in providing the medication, or losing stable housing. We’re able to keep in touch with the patient and may find problems that the covered entity may not even know about. So plain and simple, it allows us all to be on the same page, to provide the best care that we possibly can.”
-Andy Doan, PharmD, AAHIVP
Pharmacist-in-Charge at the Avita onsite pharmacy at ASHwell
Having a pharmacy onsite gives the pharmacy team the ability to fully troubleshoot any issues with coverage and providers for our patients. Because of that, we have the unique opportunity to create solutions that would be a lot more difficult or unfeasible if the prescription was filled with an external entity.
On the benefit to covered entities of having an onsite pharmacy partner:
“I’ve wanted to have a clinic with a built-in pharmacy my whole career, and now finally have the opportunity [in partnering with Avita]. Sometimes providers feel like magically if they give [a patient] a prescription, it’s going to get filled, and that’s just not the case. When you look at the flow of our clinic, you come in on the left and it’s a circle and ends with [the pharmacy] before that patient checks out. So, before that patient checks out, they go to the pharmacy and leave with their medicine. I wish that’s how every clinic was. It’s been hugely important and beneficial for our clinic, and our patients.”
-Ben Walker
Director of Client Services, ASHwell
On how comarketing with a pharmacy partner helps build engagement:
Avita has just launched SEXUWELL, a patient-facing initiative our covered entities can cobrand to educate their patients about how sexual wellness plays a crucial role in their overall health. Avita offers a variety of free cobranded marketing materials to all its partners.
“We’ve always appreciated the ability to cobrand resources with Avita. But [the SEXUWELL campaign] really gets to the heart of where ASHwell is in terms of being unapologetically sex positive. It’s great to have a corporate partner that is comfortable going in that direction too.”
-Ben Walker
Director of Client Services, ASHwell
“Something that’s so important with Avita’s cobranding with our covered entities is that it feels relatable. [The materials are] personal and very casual, but very emotionally impactful.
We can talk all day about clinical recommendations and guidelines from credible organizations, but it’s easy for a normal person to get lost in that, because they just see walls of text. Patients want to feel like they’re being cared for and that they can relate to their providers, because at the end of the day we’re all just people and we need to practice what we preach.”
-Andy Doan, PharmD, AAHIVP
Pharmacist-in-Charge at the Avita onsite pharmacy at ASHwell
On how a pharmacy partner can enhance patient retention:
“Traditionally, pharmacists have been a very accessible healthcare provider for patients. We can see exactly what the barrier of care for the patient is. Is it something like they have a medication in overstock, is it because that they ran out of co-pay assistance? Is it because they’ve moved, and we couldn’t get ahold of them?
Adding [a pharmacist] as an extra checkpoint in the patient journey gives us better opportunities to communicate with the patient, allows us to better understand what needs the patient has, and offers insights into how we can best tackle the needs of patients who may run into the same problems in the future.”
-Andy Doan, PharmD, AAHIVP
Pharmacist-in-Charge at the Avita onsite pharmacy at ASHwell
We can talk all day about clinical recommendations and guidelines from credible organizations, but it's easy for a normal person to get lost in that. Patients want to feel like they're being cared for and that they can relate to their providers, because at the end of the day we're all just people and we need to practice what we Preach.
About the Speakers:
Glen Pietrandoni
SVP, Patient and Community Advocacy, Avita Pharmacy
Glen is deeply engaged in Avita’s mission as an industry advocate and thought leader for HIV patient care and continuation of the 340B program benefiting its patients and partners. He is responsible for networking with pharma and government officials to represent Avita’s views and discuss industry activity. Glen leads the efforts to advance Avita Pharmacy programs and continues to look at educational opportunities that improve the health and the lives of the patients we serve.
Ben Walker
Director of Client Services, ASHwell
At ASHwell, Ben oversees both medical care and social services while also strategizing long-term growth. An Avita partner, ASHwell’s vision is to empower a community made up of individuals, regardless of status, station, or background, who are empowered to navigate their own sexual health and wellness without shame, stigma, or judgment. Ben has also played a crucial role in the delivery of free access to PrEP throughout Texas, as well as serving as a policy advisor for and board member of other formative organizations.
Andy Doan, PharmD, AAHIVP
Pharmacist-in-Charge, Avita Pharmacy
Andy is the Pharmacist-in-Charge at Avita’s onsite pharmacy with ASHwell. An Avita patient before his pharmacist days, Andy is incredibly passionate about patient participation in sexual health, both directly from within the community and as a healthcare provider. Andy earned his Doctor of Pharmacy at The University of Texas at Austin College of Pharmacy and is certified as an HIV Pharmacist with the American Academy of HIV Medicine.
