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August 4, 2014 PAN Foundation Offering Help and Hope for a Healthy Tomorrow Agenda • PAN Overview • HIV/AIDS Financial Assistance Fund • Application Process and Instant Approval • Summary and Questions/Answers 2 Who We Are Mission Established in 2004, PAN Foundation offers help and hope to people with chronic or lifethreatening illnesses for whom cost limits access to breakthrough medical treatments. Independent Board of Directors 11-member board with diverse expertise in healthcare, non-profit, financial management, public policy industries Proud to Say… Helped over 295,000 patients in the last 10 years 99% of patient and providers report satisfaction with our services 95% of each dollar donated goes directly to patient assistance Nearly 60 disease-specific programs cover a wide range of patient needs by partnering with the largest providers and 20+ manufacturers 3 PAN Assistance Programs Oncology Anaplastic Large Cell Lymphoma Basal Cell Carcinoma Bone Metastases Chemotherapy Induced Neutropenia Chronic Lymphocytic Leukemia Chronic Myeloid Leukemia Colorectal Cancer Cutaneous T-cell Lymphoma Gastrointestinal Stromal Tumors Immunotherapy for Genitourinary Cancers Hodgkin’s Lymphoma Lung Cancer (Non-Small Cell) Mantel Cell Lymphoma Metastatic Breast Cancer Metastatic Castrate Resistant Prostate Cancer Metastatic Melanoma Multiple Myeloma Myelodysplastic Syndrome Myeloproliferative Neoplasms Neuroendocrine Tumors of Pancreatic Origin Non-Hodgkin’s Lymphoma Renal Cell Carcinoma Thyroid Cancer Rare Disease Acromegaly Cushing’s Disease Gaucher Disease Homozygous Familial Hypercholesterolemia Methicillin-resistant Staphylococcus aureus (MRSA) Short Bowel Syndrome Tuberous Sclerosis Complex Uveitis Wilson Disease Travel Assistance Metastatic Castrate Resistant Prostate Cancer Premium Assistance Chronic Illness Asthma Auto-Immune Diseases • Ankylosing Spondylitis • Plaque Psoriasis • Psoriatic Arthritis • Rheumatoid Arthritis Chronic Iron Overload Cytomegalovirus Growth Hormone Deficiency Hepatitis B Hepatitis C HIV/AIDS Idiopathic Thrombocytopenic Purpura Inflammatory Bowel Disease • Crohn’s Disease • Ulcerative Colitis Lower Extremity Ulcers Macular Diseases Multiple Sclerosis Postmenopausal Osteoporosis Respiratory Syncytial Virus Retinal Vein Occlusion Secondary Hyperparathyroidism Solid Organ Transplant Immunosuppressants Homozygous Familial Hypercholesterolemia Short Bowel Syndrome 4 Patient Demand Continues to Grow • YTD June—110,910 patients have been approved for financial assistance vs. 43,262 the prior year Total Patients Approved 32000 31023 Number of Patients Assisted 27000 22000 15489 17022 17000 16376 16349 14651 12000 2000 7018 2578 1185 January 2012 10101 9358 7000 2011 7257 5259 1216 1551 February March 5966 5685 4491 4184 1060 April 816 May 8095 4895 5468 3290 3692 34205715 888 1136 1101 June July August 5389 4054 1100 September 7929 4389 850 October 2013 6849 3957 982 6870 2014 4356 1858 November December -3000 5 Key Performance Indicators Inbound Calls • YTD, PAN has received 279,856 calls • Average speed to answer 43 seconds* Patient Approvals and Payments • • • • • YTD, PAN has approved 114,921 applications 99% of application are processed within a business day Approval rate of 97% No. 1 reason for denial is income greater than criteria Total payments YTD $238,564,874.11** Application Point of Entry 15% Provider Portal 22% 42% 21% SP Portal Phone Website Referral Sources • 45% of referrals come from providers • Pharmacy referrals have increased significantly to 38% *Average speed to answer is calculated using the last six months. **Total payments is calculated through June 2014. Referral Sources 4% 11% Provider 15% Reimbursement Support 38% Patient Advocacy Website 45% Pharmacy 1% Case Manager/Social Worker 6 Patient and Provider Satisfaction Surveys Objectives •Understand effect of co-pay assistance on adoption of therapy and continuity of care •Assess patient and provider satisfaction with PAN services Key Findings in 2012 •High out-of-pocket expenses associated with medications are #1 reason why patients fail to begin or continue treatment •Assistance from PAN helps patients comply with their medical regimen •Assistance from PAN allows patients to pay other bills, relieves stress, and positively impacts their overall health •Overall, patients and providers were satisfied with PAN’s services 538 Patient surveys completed; 430 Provider surveys completed 7 2012 Satisfaction Survey Findings 98% of patients are satisfied with PAN’s services 89% of providers are satisfied with PAN services Q7. Using a scale from 1 to 5, where 1 is Very Unsatisfied and 5 is Very Satisfied; please rate your Satisfaction with PAN Foundation services? N=530 8 Co-pay Expense: #1 Barrier to Treatment Q. 1 Which factors, if any, affected your ability to begin the treatment recommended by your doctor? Q2. Which factors, if any, have affected your ability to continue (comply) with your treatment recommended by your doctor? (Check all that apply.) 2011 N=~500, 2012 N= 512 9 Patient Compliance Increases In 2012, assistance from PAN allowed 97% of patients to comply with taking their medications vs. 39% without assistance. Before PAN's Assistance After PAN's Assistance 3% Unable to Comply Unable to comply 61% Complied 39% 97% Complied Q.4 Prior to receiving assistance from PAN, were you able to take your medication as prescribed by your doctor? N=504 Q.5 Now that you are receiving co-payment assistance from PAN, are you able to take your medications as prescribed by your doctor? N=520 10 HIV/AIDS FINANCIAL ASSISTANCE FUND 11 HIV/AIDS Program Assistance Patient eligibility criteria: • Patient is insured and insurance covers medication for which seeking assistance • Patient's income must be below 500% of the Federal Poverty Level Relationship Flow: DONOR Patient Reporting Donor Agreement & Donations Application Approval / Denial Letter • Patient must reside and receive treatment(s) in the US and its territories • $4,000 per year, with the ability to receive another $4,000 if funding is available Application PAN Foundation Approval / Denial Letter Medication Information SP/Provider 12 PAN: The Only Co-Pay Foundation Providing Financial Assistance to Patients with HIV/AIDS • Since April 2014, PAN has provided financial assistance to 1,617 patients with HIV/AIDS Requests for PAN financial assistance from patients with HIV/AIDS has continuously increased over the last few months • HIV/AIDS Monthly Patient Activity 2014 800 696 Number of Patients Assisted 700 665 600 500 400 300 2014 256 200 100 0 April May June July August September October November December 13 Specialty Pharmacy & Provider Relationships PAN partners with many key specialty pharmacies, including: and many providers…as well as patient advocacy organizations 14 Specialty Pharmacies are an Important Role in Point of Entry & Referrals Majority of applications for the HIV fund are submitted electronically, via specialty pharmacies or large practices HIV Application Point of Entry HIV Referral Sources Provider Portals 26% 31% Phone 43% Website 26% 3% 5% Reimbursement Support 34% Patient Advocacy Website Pharmacy 30% Case Manager/Social Worker 2% 15 APPLICATION PROCESS AND INSTANT APPROVAL 16 Streamlined Channels for Accessing PAN Assistance • Apply Online: www.PANfoundation.org • Apply Over the Phone: 866-316-PANF (7263) • Specialty Pharmacy/ Provider Online Portal 17 Application & Claims: A Rapid Response • PAN offers a variety of ways for patients, providers, and advocates to submit applications for financial assistance for high-cost specialty medications ‒ Ability to “virtually “sign the application across all points of entry Patients or Advocates seek assistance By Phone Staff approve patients according to PAN eligibility criteria Patients receive treatment PAN pays claims to pharmacies, physicians or patients Website/Portals 18 Portal Enrollments: Submission Validation Immediately Displayed in Online Portals • Same streamlined enrollment application, now with immediate results • Once application is submitted, pop-up will appear to show in-process determination 19 Portal Enrollments: Patient Eligibility and Billing Information Instantly Shared • In under ONE minute, eligibility determination, billing information and available balance will be populated within the Portal allowing for instant dispensing of medications 20 Provider/SP Portal – “Real-Time” Patient Status Specific Patient Information for Provider/SP ‒ Allows Provider to view information on all of their enrolled patients ‒ Alerts remind Provider that there is missing information that must be completed for an application review 21 “Real-Time” Mechanism for Tracking Claims & Account Data Specific Patient Information for Provider/SP ‒Amount allocated to patient ‒ Payments pending ‒Total payments made ‒Patient’s account balance 22 Summary —PAN Offers Hope for Patients and Help for Families • Significant Growth: – Thousands of patients are able to comply with their medication regimen because of financial assistance from PAN • Disease Programs: – Improved application process • PAN’s Instant Approval system has made our enrollment acceptance time the fastest in the industry – Efficiencies • Patient transaction cost has been reduced by more than 40% • Service Excellence: – Despite significant increase in demand, customer service is excellent • Experienced and well-trained staff • Solid infrastructure in place to handle current and future growth 23 Contact Information http://PANfoundation.org Korab Zuka Vice President, External Relations and Patient Services Tel: 202.347.9273 Cell: 202.344.5551 E-mail: [email protected] Facebook.com/PANfoundation Twitter.com/PAN_Foundation 24