Insights from 2017 Industry Leaders: Patient Assistance and Access Programs

CONTENT CONNECTIONS
I N S I G H T S F R O M
2017 Industry Leaders
A division of
UBM Americas
PAP201718th
Annual Patient Assistance & Access Programs
Lighting the Path Forward and Navigating Complex Change
March 16-17, 2017 • Renaissance Baltimore Harborplace Hotel • Baltimore, MD
Discover What’s Next in Access and Prescription Assistance

LASH GROUP, PART OF AMERISOURCEBERGEN
Tracy Foster,
President,
Lash Group, part of AmerisourceBergen
TRACY FOSTER
How do you foresee the recent changes in administration shaping and/or impacting the future of patient support services?
Certainly, the new political dynamics in Washington hold the potential to usher in a fairly significant shift in the healthcare landscape,
particularly as it relates to patient access. With the future of the ACA in doubt, it remains to be seen just how people’s access to
healthcare insurance will be affected by broad changes. However, whatever happens in DC, one thing we do know is that consumers are
increasingly demanding and savvy, so they are going to exhaust every option to gain access to the medications they need. Given this,
we could expect to see an upsurge in demand for services from manufacturer programs, and that is something in which we all should be
prepared no matter the final policy outcome. If you want to know more of the potential policy outcomes, I would encourage you to attend
the Adapting to ACA Uncertainty session, led by my colleagues at Xcenda.
How is your company working to instill a commitment to patient assistance and access in your corporate culture?
We’ve found that one of the biggest challenges we face in our industry is the continuously shifting dynamics in the marketplace require
our leaders and associates alike to think and work differently. And given the rapid rate of change, it can be challenging to recruit and
retain talented associates who embrace that change. At Lash Group, we have instilled a common commitment to improving the patient
journey — each of us “work with purpose” each day in our specific roles to ensure best support for patients. We also promote a culture
that is dedicated to demonstrating core values like collaboration, innovation, and accountability; encouraging fun; ensuring integrity; and
rewarding performance. And, we’ve made considerable investments in associate engagement, training, and quality improvement programs.
As a result, our associates not only have the skills required for today, they are fully prepared to thrive as the next wave of change impacts
our business. Although we’ve constantly evolved our recruitment and associate development programs, one thing has remained constant
since I joined Lash Group twenty years ago. That is our associates’ commitment to the patient. And in everything we do, we take a patient-
centric approach. This focus on the patient has served us well and I believe it will continue to be a key to our success for years to come.
How is the role of technology evolving and what are the challenges and benefits associated?
One of the hot topics over the past year has been around Artificial intelligence (AI) / Machine Learning, and it’s very exciting to see this
cutting edge technology move into the healthcare space. AI will provide the capability to utilize existing historical data to predict with
high confidence medical and pharmacy benefits for patients, and a whole host of other services. Lash Group is positioned to be able to
support this type of technology, and we are excited that it will positively impact patients, speed time-to-treatment, and improve efficiency
within the healthcare system as a whole. Having the ability to use valuable information to improve health outcomes aligns with our
commitment to ensure that we put patients at the center of everything we do.
Just for fun…
What has been your biggest career highlight to date?
One of the things that I am most proud of over the course of my career is that I have led our company’s growth from 30 associates
(in 1996, when I joined our Charlotte office) to over 4,000 associates today.
What was the best career advice you ever received?
Someone told me once that “culture matters.” As an employee, it is important to seek out a company culture that aligns with your
personal values and goals. As a leader, it is our priority to nurture a culture of aligned goals and values.

PATIENT SERVICES, INC.
How do you anticipate the relationship between manufacturers and foundations changing over the next few years?
We currently are in a very unique patient assistance environment. Government regulatory agencies are scrutinizing both industry and non-
profits in part due to the attention garnished from Martin Shkreli’s stance toward Congress and pricing. More decisions are being made
by compliance people than commercial or public policy/advocacy people in regards to assistance which can be provided. In other words,
compliance will be a greater concern moving forward as many are becoming more skittish in this environment.
What does the future look like for PAPs?
PSI is finding that insurance companies are seeking to curtail third party payments by non-profits on behalf of chronically ill patients.
Over thirty-eight states and sixty insurance plans have prohibited these third party payments. In addition, some states are seeking to pass
legislation outlawing manufacturer coupon/copay assistance programs. PSI is very involved in advocacy to challenge these efforts and has
found great support in Congress! As we move into the future, patient populations, advocacy groups, and all who have a stake in providing
patient assistance will need to coordinate efforts in order to insure patients have continuing access to therapy
What are you most interested in hearing about/learning at this year’s conference?
In light of the challenges provided by the current regulatory environment, I am very interested in hearing discussion about how industry,
advocacy groups, and patient assistance foundations are addressing these barriers to access for patients.
Just for fun…
Where is the most interesting place you have visited and why?
My dad was an Editorial Cartoonist for several major newspapers, but his claim to fame was collecting original cartoon and illustration art.
Thus, the most interesting place I visited was anywhere my dad went to see a well know cartoonist or artist to ask for a sample of their
work and hearing their stories. Cartoonists are a crazy group of people who have a unique way of looking at the world!
If you could give yourself career advice when you were first starting out, what would it be?
You will probably not end up where you originally planned, so accept the bumps and detours as part of the process for shaping who you
will be and what you will do!
Art Wood,
Senior Vice President,
Patient Services, Inc.
ART WOOD

EISAI, INC.
Bill Goodson,
Director, Market Access and Reimbursement Services,
Eisai, Inc.
BILL GOODSON
PAPs will never go away. We will always have patients that remain uninsured and a new demographic of underinsured patients.
Depending on the new administrations ACA guidelines we may see PAP’s expand. Every manufacturer will have to decide on how they
want to structure their PAP programs based on the disease state, what the competition offers, the cost of your product, what you will
cover under PAP and how generous you can afford to be.
Patient assistance and access is a huge part of our culture within the company. It is really the foundation on assisting patients having
access to our products. It will continue to evolve as we bring better products to the market to improve patient’s lives.
We are seeing a slow shift from the manual processes of patient support services to electronic processes. Are we there yet? No. We still have
problems with all the different systems able such as EHR’s, the hub, the SPP and the manufacturers to connect to streamline the process. If we
can solve the technology issue then providers and patients will benefit.
Just for fun…
Sit back, be quiet and listen to people who know what they are talking about so you can benefit from their knowledge and create your
own success.
Serving my country and making a difference in patient’s lives.

CHURCHILL PHARMACEUTICALS LLC
Frank Barrett,
Executive Director, Patient Support Services,
Churchill Pharmaceuticals LLC
FRANK BARRETT
It is going to be interesting to observe how the new policies and legislation impact affordable patient access. In some respects, it appears
as though potential changes to Medicaid, possibly in the form of block grants, could reverse the recent downward trend of enrollment
in manufacturer patient assistance programs. Previously as ACA was implemented, and 32 states expanded Medicaid, manufacturers
experienced large declines in patient assistance enrollment. Most of the change was a result of large states that expended their Medicaid
programs including California, Arizona, Pennsylvania, Illinois and New York. As new legislation and policies are implemented, I believe we
are going to see the need for new and innovative programs as well as large enrollment increases for patient support services, especially for
PAP, as coverage policies for branded medications change once again.
Having worked very successfully with many of the larger, and very reputable, third-party foundations for more than 13 years in the areas of
Oncology, Immunology, Respiratory and Nephrology, I find the current trend disappointing. Given the government scrutiny of third-party
foundations, I’ve noticed donations are down and many programs are unavailable to new patients. I assume this going to negatively impact
patients that rely on these funds, especially federally funded patients that don’t have access to manufacturer copay programs. My hope
is that there is additional guidance issued by the OIG and that pricing concerns are addressed by manufacturers to once again encourage
donations foundations.
I’ve been fortunate to work in the area of pharmaceutical patient access for many years with large companies including Centocor, AstraZeneca
and GSK. I’ve seen the policies of different administrations directly impact patient assistance and access to innovative and life-saving therapies.
When George H Bush introduced Medicare Plus Choice (Part C), patient access increased and enrollment in PAP declined, only to reverse trends
again when Bill Clinton cut funding to the Medicare Part C Program and insurance companies withdrew. After the Medicare Modernization Act
was implemented in 2006, new patient assistance programs were created to help ease the cost-sharing burden of Medicare Part D and the
infamous donut hole. As the Affordable Care Act was implemented in 2011 - 2015, patient assistance enrollment numbers dramatically decreased
due to affordable access in Healthcare Exchanges and expanded Medicaid Programs. The impact of PAP will largely be determined on the
policies Secretary Price implements and, judging from early news reports, there will be a strong need for patient assistance in the future.
Just for fun…
The best career advice I received was from my mentor Dave at GSK. He advised me to be persistent and resilient in all aspects of my
career and to not let failure derail me. Often Dave reminded me of people like Abraham Lincoln who ran for office and lost many times
before being elected, Walt Disney who was fired before succeeding with the movie Snow White and Steve Jobs who was fired from the
company he founded. Successful individuals frequently have failures and detours in their careers he always reminded me, but they do not
let those bumps deter them. Often, he would remind me to look at failure as a part of success and detours to be seen as opportunities to
possibly advance my career.
If you could take any celebrity to dinner, who would you choose and why?
Bruce Springsteen. I’ve been listening and admiring Bruce since I was a junior in high school. I have fond memories of going to his concerts in
Philadelphia, especially the concert before Christmas in 1980 when Clarence Clemens played all night dressed as Santa Clause. Through the years,
I Springsteen has written many songs about his life experiences and I’d like to learn more about him, his life experiences and his creative process
which has produced 20 albums.

UBC
Nicole Hebbert,
Vice President, Patient Access & Engagement,
UBC
NICOLE HEBBERT
Our team’s commitment to high-touch care for our PAP programs is the foundation for our culture of patient and product advocacy.
Each year, UBC’s Patient Assistance Programs help thousands of patients initiate and maintain access to critical therapies. Despite these
incredible numbers, our frontline staff of patient care advocates and pharmacists provides personalized care and attention to each patient.
Our entire team is committed to a hands-on approach for every PAP we support, ensuring program compliance and patients’ prompt
access to critical therapies.
The future for PAP is bright when stakeholders come together and keep patients first. More and more, collaboration among service
organizations, foundations, regulators, and manufacturers is necessary if we want to drive an industry shift. We must collectively
update our understanding of the PAP patient as their demographics continue to change. We must partner with regulatory agencies
to educate on today’s PAP challenges so they can refine policy and guidance that will protect and enable appropriate use. Lastly, we
must power innovation and the use of technology to enable speed and compliance.
Today’s technology is shifting from large traditional EMR/ERx and Pharmacy Management Systems to targeted services aimed at
improving speed to therapy. Two immediate examples of new targeted services supporting the PAP industry are electronic income
verification and electronic benefit investigation. Electronic income verification determines the patient’s income range in real-time as
opposed to manually collecting income data and/or auditing self-reported income statements. The second example, electronic benefit
investigation, allows the PAP provider to re-verify the patient’s commercial or government insurance status.
Just for fun…
Where is the most interesting place you have visited and why?
Panama, specifically the Panama Canal. My husband’s family is originally from Panama and I have visited the diverse isthmus several times.
The mix of Caribbean and Central American cultures has created an amazing range of food, music, customs, and national pride. But what
I found myself most in awe of was the Panama Canal. With connections to the Panama Canal Authority, my family and I have had the
opportunity to get up-close and personal visits. The daring idea, the engineering genius, and the human dedication and sacrifice that went
into the original construction has created an amazing piece of world history.
Early in my career I was told “strive for progress, not perfection.” For Type A personalities, like myself, this phrase feels counterintuitive but
it has positively influenced my thinking and guided me on many occasions.

TRIPLEFIN
Tom Doyle,
Executive Vice President, Commercial Services,
Triplefin
TOM DOYLE
While the path forward is still undefined by the new administration, I believe the need for support services will continue to increase.
Access to innovative products remains out of reach for many patients and the programs developed by manufactures will continue
to play a key role in address the needs of patients who are not supported through government programs or strong commercial
insurance plans.
The need for PAP will remain strong and technology will continue to drive innovation to improve access and reduce traditional
manual processes.
Our focus as a service provider has centered on improving health outcomes and reducing health care cost. This is part of our DNA and
through both our wholesale distribution (H. D. Smith) and patient service company (Triplefin), our teams focus on how to link all activities
to improve the patient and provider experience.
Just for fun…
Play to your strengths, understand your gifts and enjoy what you do. Find a path where you can leverage your skills & passions and strive to
work with people that are focused on doing the right things.
While working at a researcher in the Genetics Lab at Henry Ford Hospital, I was told by the physician in charge, “you will be an average
scientist but are great with people”, He moved me into the clinic counseling high risk pregnancy patients. 25 years later, I am still in
Women’s Health Care, having led brand team, distribution companies and patient services with a focus on improve access for women to
gproducts in numerous disease states.

UNIVERSITY OF VIRGINIA HEALTH SYSTEM
Melissa Paige,
Pharmacy Patient Medication Principal Coordinator/Cancer Center,
University of Virginia Health System
MELISSA PAIGE
We are seeing a large shift at our facility with Buy and Bill medications being mandated to go through the Pharmacy Benefits (SPP).
Not all Manufacturers have the capability of allowing copay cards obtained for commercial patients to be used, and the patient can’t
afford the copay. These cases are being pushed over to Patient Assistance as a last resort, and these cases are taking three times as
long trying to get a solution for.
We have created our own HUB system of Subject Matter Experts for PA, BI, OOP Patient Access, and created our own onsite SPP
to help with all prescriptions we can. This same team also helps with all Medical side Buy and Bill treatment options, patient access
(Pap, Copay, INO) when it’s been or we know it will be denied (off-label). Also Next year at the Patient Assistance Conference I
would like a Jeopardy game to be done, so manufacturers can see how much navigation is being done, and the many hoops we have
to jump as Advocates.
Everyone is after the same goal of patient access, and trying to make it easier for the HCP’s. Everyone has a portal, and while they are
meant to be helpful, offices are having a hard time navigating and submitting requests through each one. Some of the challenges are
anytime a Physician’s email is asked to gain access to the patients that the physician already signed an application or copay card for. We
are struggling, because we need to see this information (Pap application status, account balance, enrollment period, COB information) and
with a facility as large as ours (45 Physicians who can write for medications) it’s impossible to use any portal requiring a Physician’s email
to log him into the account. There are multiple portals for the same manufacturer for the HUB services, Patient Assistance and Copay.. let’s
simplify. Suggestion? Open API and someone come up with the Multi-Billion dollar product with a one portal for all.
Just for fun…
You’re going to be told “No” a lot, and it’s your job to navigate until it’s a “Yes”. You’re going to be a part of every family that comes in contact
with you, and you’re going to feel all the emotions they are, when trying to find a solution. You’re going to see parents walking out of rooms of
their children who are nearing the end, just to go try and sign for a signature loan that you know they won’t be approved for just to afford the
$10,000 medication that the insurance is denying. Don’t ever give up, you’ll find ways to help these families make it possible to send their child
home to spend another 3 months and see one more Christmas. The manufacturers want to help, and the Field Reimbursement Teams are your
greatest asset so reach out! They have a hard enough time trying to navigate the complexity of every account, help them out and you’ll watch
them help you move mountains, and gain lifelong friends.
Having my own company where I have consulted with a major manufacturer as they prepped to launch an Immuno-Oncology medicine. I
also had the opportunity to participate in their National Launch meeting for a Panel Discussion. I wanted to bottle up all that energy and
passion felt at that meeting to give to our patients, and show them that we are all here for the same end goal.

NORD
Catherine Blansfield,
Vice President, Access and Outcomes Services,
NORD
CATHERINE BLANSFIELD
Attention to state actions regarding health care initiatives is essential. A majority of states are not measuring up regarding legislative
solutions that reduce the burden of rare diseases affecting 30 million Americans. NORD’s Rare Action Network was created to
ensure that the rare disease community is represented and supported in their advocacy actions within all 50 states as they strive for
changes which will better their lives.
NORD, who has served the rare disease community for nearly 35 years, knows too well that patient’s health care needs extend beyond
medications. Several manufacturers are beginning to support programs which are aimed at overcoming obstacles to other important
treatments which are essential for good health and we applaud these inclusive, disease focused and patient centric, actions.
I am pleased to note the patient-centric focus of many of the sessions at this year’s conference. It is very much in keeping with NORD’s
ongoing priorities of educating and empowering individuals, their families, and disease specific organizations associated with rare diseases
in gaining optimum patient and provider support services.
Just for fun…
I prescribe to the teachings of Peter Drucker. One example of his vast wisdom which I have followed regarding business management principles
is his belief that to be effective one’s focus should be upon contributions rather than achievements.
If you could take any celebrity to dinner, who would you choose and why?
Steven Spielberg since I consider him a creative genius, a trailblazer, and the standard bearer for all future filmmakers, which are qualities
I greatly admire. His movie on Lincoln is one of my all-time favorites.

HORIZON PHARMA
Kristina Broadbelt,
Director, Global Patient Advocacy,
Horizon Pharma
KRISTINA BROADBELT
At this point, it seems to be a “wait and see” approach. Nothing about this administration is following a predicable pathway.
The important thing here is that all the stakeholders — industry, patient advocates and families, physicians — stay on top of
what’s happening and communicate with each other and to those making these decisions.
I truly believe as patient need evolves and changes — along with regulations — communication will be the key to working within the
system to help those patients and families in need. Meeting like this are integral to spur that conversation and elicit actionable ideas
that put into practice. And, patient advocacy groups and patient opinion leaders must be a part of that conversation.
At Horizon, the patient is at the center of everything that we do every day. Because of that, and because of a culture of teamwork,
transparency and proactive communications, assistance and access is a topic that is discussed quite frequently. We are always listening to
feedback from patients and families, clinicians and Horizon representatives that interact with these important stakeholders and then acting
on that feedback. This has resulted in innovative support and assistance programs that go beyond providing access to therapy.
I am most interested in learning ways that other companies are supporting patients that we may able to implement. The greatest minds
and leaders in patient assistance will at this conference and I plan to learn as much as I can from them.
Just for fun…
The best career advice I have ever received is around being a good leader. Surround yourself with skilled, emotionally intelligent people and
pave the way to let them what they do best. This advice has never failed me.
My biggest career highlight just happed this Rare Disease Day a few weeks ago. A patient advocate that I work with tagged me in a
social media post thanking me personally for the work I do to support their rare disease community and the difference that has made.
This is an individual who I consider a personal hero thanking me? It doesn’t get better than that.

PAP201718th
Annual Patient Assistance & Access Programs
Lighting the Path Forward and Navigating Complex Change
March 16-17, 2017 • Renaissance Baltimore Harborplace Hotel • Baltimore, MD
Discover What’s Next in Access and Prescription Assistance

Insights from 2017 Industry Leaders: Patient Assistance and Access Programs

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