Case Studies

The Challenge

In the United States, pharmacy benefit managers ("PBM") are responsible for the administration of drug benefits for over 200 million Americans. With the number of injectable prescription medications prescribed today, the management of syringes generated from the self-administration of these drugs is a particular challenge facing PBMs.

One managed care organization's internal PBM with over 70 million members forecasts unique specialty Rx patients, excluding diabetics, to equal 70,000 in 2011. This PBM was interested in improving the quality of the patient experience, exceeding industry best practices and protecting employees and the public from potential needlesticks. In such a competitive industry, they were also anxious to present offerings beyond what their competitors were providing.

While the company was already providing non-mailback sharps containers to self-injecting patients, the most frequent question asked of customer support by patients was what to do with the full sharps containers. In the states where it is illegal to place sharps into the solid waste, customer support reps had to research drop-off sites for each customer. Even if a particular state had no laws against trash disposal, the PBM did not feel comfortable suggesting trash as an option. These types of conversations were occupying valuable time that should have been spent assessing patient compliance and outcomes regarding their medication, not syringe disposal. This was not how the PBM wanted to spend its customer support budget; however, they believed they had no other viable options.

The Solution

When Sharps initially started working with this PBM client, they provided a combination of mailable and non-mailable solutions for their patient population on injectable home-administration therapies. Product mix flexibility was an important element in the selection of Sharps as the exclusive provider of these systems for their patient population. Unlike previous patient offerings, the Sharps solutions offered patients the mailback, which solved the challenge of how to dispose of full containers. Product sizes included 1-Quart, 1-Gallon, and 2-Gallon mailback and non-mailback options. The mailback option for patients offered a competitive edge over other PBMs who only offered sharps containers with no disposal option.

In addition to these best practice protocols for patient and caregiver safety, PBMs can utilize the systems to provide key messaging and reminders about the therapy. Unique Sharps-provided container labeling includes the 800 number for the call center so that the receiving patient always has easy access to one of the PBM's clinical call center professionals. Messaging around adherence support (compliance and persistency) can also be incorporated into the program. Secondary labeling or branded collaterals with each fulfillment can help patients further understand the benefits of staying on therapy long-term. Currently the client is providing these solutions nation-wide directly through their own distribution channel. Sharps has implemented a reverse tracking program solution in order to notify the client when a system is received at Sharps' treatment facility. The client can then contact the utilizing patient for further enhanced communication and improved patient experience.

Given the increasing regulatory requirements around the disposition of home-generated sharps, the client is increasingly utilizing the mailable systems when distributing drugs to patients in states where trash disposal of sharps is prohibited by law. Patients themselves learn about and request a mailable solution to assure not only proper containment, but safe return and recycling of used needles, syringes, and other injection devices associated with their therapy.

In order to help customer support understand product selection and disposal options, Sharps provided product training for the call centers. Being able to assure patients that their mailback systems would be recycled, and not incinerated or end up in a landfill made not only patients feel better about their disposal option, but the customer support representatives were excited as well.

The Result

The 70-80,000 systems provided to patients per year currently include both mailback and non-mailback. Patient satisfaction has improved; and customer support personnel and patients alike have responded well to the ability to mail full sharps containers right from the patients' homes.

The 15-20 minutes previously spent on disposal research by customer support was eliminated, reducing costs and increasing time dedicated to patient compliance to their medication protocol.

Increased patient loyalty due to providing patients with a complete containment and disposal solution is difficult to measure. "However, providing that extra convenience for our patients has made our jobs and our patients' lives much easier. They won't get that somewhere else."

Based on the client's acceptance and utilization of the program and Sharps' ongoing commitment to innovation, the client elected to roll out a similar program for their insulin-dependent population through its patient support program.