Kelly J Wendlandt (00:01.493)
One, and we are live with Rob Moore, Melissa Brown. How are both of you this morning?
Rob Mohr (00:08.025)
Doing great. How you doing, y’all?
Melissa Brown (00:08.866)
Kelly J Wendlandt (00:11.321)
You know, I don’t want to toot any of our horns too much, but I feel fairly impressed with the three of us to be on a call within a minute prior to this call and all jumping into this call and just shifting gears that quickly where we’re, you know, I don’t know about YouTube, but I was frantically trying to get the website up for this hosting platform and getting my microphone plugged in. So it was a little bit of a circus atmosphere here.
Melissa Brown (00:12.598)
Kelly J Wendlandt (00:40.449)
And then I was telling Rob Melissa, my lighting, my lighting in the winter doesn’t work, so I have to, I have to turn my computer to this side. So it looks like I’m trying to show off my degrees above me here, my different. I’m not trying to show anything off there. I think that one’s from grades. That’s a grade school one. And that one is a GED or something. So, um, so we were talking, uh, you know, I guess a week or two ago in, and I’ve
Rob Mohr (00:51.457)
Melissa Brown (01:00.424)
Kelly J Wendlandt (01:10.477)
Other people talk about the same subject, and it was specialty drugs. And I happen to have some experience with specialty drugs, and it’s very interesting to me. And so I wanted to talk to both of you. My understanding is that our e-prescription group recently has been doing more specialty drug work. Is that correct?
Rob Mohr (01:35.917)
Yeah, from different angles, right? So one project that Melissa can talk about is from the pharmacy angle, but we also work with it from the specialty drug manufacturer angle as well to assist with programs to make these drugs affordable through copay programs, stuff like that. So different angles, different needs, and there’s a lot of opportunity there, so it’s a good area for us.
Kelly J Wendlandt (02:01.709)
What is a specialty drug?
Rob Mohr (02:04.105)
Yeah, in preparation for this, I was gonna actually do some looking up because, you know, in a very generic sense…
It’s something that requires maybe a special pharmacy because only people, those pharmacies can distribute it because maybe it has to be kept at a certain temp and it has to be, only it’s limited, ones that not every, a CVS or Walgreens is not gonna have it in stock. Or in the case of what Melissa’s working on, it’s a complex infusion type of drug that is gonna be a compound drug of several different compounds that obviously your corner drug store is not gonna put together.
And then the other side of it, from the payer side, a specialty drug could be covered by your PBM or your medical plan based on how you’re getting it administered, if you’re getting it like an infusion in the hospital setting or something like that. I’m sure there’s more complex definitions, but how it affects us is kind of that.
Kelly J Wendlandt (03:02.461)
Okay, all right. Yeah, my wife recently needed a specialty drug, you know, and so we had to call up our health care provider and our insurance provider and she’s calling all around the country because apparently there’s only one or two places in the country that make this drug and then it was non-traditional use of the drug and so is that that’s really what it is. They’re not
Rob Mohr (03:29.953)
Kelly J Wendlandt (03:31.211)
They’re not as common and they’re a lot more expensive is that basically what, yeah. Yeah.
Melissa Brown (03:31.31)
Yeah, yeah, yeah. And like the large majority, I would say the vast majority because of the high cost, they require usually a prior authorization. So when I think of specialty drugs, I go back to the patient experience. And if you’re on a non-specialty drug, you’re not going to be able to get a special treatment.
Rob Mohr (03:34.681)
Yeah, that’s two characteristics, right?
Melissa Brown (03:54.658)
For example, let’s say you find out today that you have hypertension. You can be provided that diagnosis and the prescriber will write you a prescription and go to the pharmacy and get it within a matter of hours. But if you come to learn that you have some kind of disease state that requires a specialty medication, often you’re not gonna be able to get on that medication today. It might take days or weeks before you end up being on that. And you know, that’s like, in my mind,
challenges that I think the industry faces to get patients on the medications a lot quicker. So you’re not only learning that you have this condition, but now you have to jump through a number of hoops, one of which is always going to be a prior authorization. So you have to get approved for it. And then what will happen typically in a lot of cases is not only now it’s covered, but it’s really expensive. So then you have to help the patient or the, you know, find maybe a reimbursement.
or some kind of financial assistance program that can help with that. So there’s just a lot of hoops to jump through for the prescriber and the patient, but I think there’s a lot of opportunities there for integration. And when I think about the work that we’ve done, we’ve helped with the prior authorization process.
also implementing solutions that provide pricing transparency. So, okay, it’s covered, but now what is it going to cost? So I feel like we’ve worked on a lot of projects here at Logisol that have really touched on all of those different places within the workflow. But they’re all none of them are really fully, fully integrated to take the patient from beginning to end in supporting that process for specialty meds. So I, I love working on these kind of projects
takes me back to the patient and seeing what value we can drive to the patient to have better outcomes. So I love it whenever we get to work on these types of projects in the space.
Kelly J Wendlandt (06:00.621)
Yeah, it’s a frustrating from a customer patient perspective. The process is very frustrating. I can tell you that. And so Melissa, you were mentioning that Logisolves group has worked on the integration and prior authorization. Are those two big components of, you know, instead of it taking two weeks or a month to try to get the thing approved through your insurance company, that automates that process? Or what exactly does that do?
Melissa Brown (06:29.782)
Yeah, that’s correct. It speeds up the timeline because there is integration there to get that approval a lot faster than if it were faxed. And then oftentimes, you know, they can get the clinical information a lot faster. And it just really speeds up the process from beginning to end, which helps get that patient the medication that they need. And it also reduces.
the need for additional staff if it’s an automated workflow at the prescriber’s office or at the payer or the pharmacy. So it helps in that regard as well.
Kelly J Wendlandt (07:08.797)
Is that work different than the more traditional e-prescription integration work your group does, or is it pretty similar? It just happens to be with taking this specialty area, which is specialty drugs, and using those same techniques to try to make that process smoother and more integrated and automated.
Rob Mohr (07:29.529)
Prior Hoth isn’t limited to specialty, right? Prior Hoth is for any type of drug that might require some additional information. But to answer your question, it’s eligibility, formularity, Prior Hoth are all in additional sets to the e-prescribing solution, right, so e-prescribing is kind of a name that infers like just a script, but there’s so many supporting transactions around that, that Melissa was referring to, EPA being one of them, you know, the
the benefit check that tells you the pricing and if it needs prior auth, stuff like that, are the transaction sets that we work with on the technical side.
Kelly J Wendlandt (08:08.081)
Okay. And so are you actually working with the insurer and the prescriber and the pharmacy benefit management group and the physicians? Are you, you’re working with all of the groups in that whole?
Rob Mohr (08:23.281)
Every side, every side of it, we’ve got clients that, if you look at the space itself, you got clients that represent, like you said, the PBM, which would be the pharmacy payment side. But we also are dealing with clients now that are working with the medical payment side, because some of these drugs are covered by the medical side. And then you have hubs or companies that work with specialty manufacturers that,
Melissa Brown (08:24.43)
Rob Mohr (08:51.109)
services to just talk about what Melissa just talked about, easing the pain of their approval process for the patient and also offering assistance programs that a drug that costs thousands and thousands of dollars might have a co-paid program that they didn’t know about but now we can interject that electronically and tell a physician. There’s many cases where a physician can’t keep up on all the drugs.
that have these programs. And so if you have ways to interject it into the EMR and say, hey, this drug has a co-paid program and this is how you go about applying for it, you could imagine how that not only saves money, but helps adherence because they’re not gonna walk away because it’s too expensive.
Melissa Brown (09:31.658)
Kelly J Wendlandt (09:34.914)
Do you get the sense that any one of the groups you work with is more interested than others in getting the process automated and making it easier for customers? And conversely, do you get the sense that… I got to tell… The reason I’m asking this question is because from the customer perspective, it feels like the insurance company doesn’t want to pay for the specialty drug. That’s how it feels. Whether that’s true or not, I don’t know, but I can tell you that’s how it feels. And so…
behind the scenes are they secretly dragging their feet and putting obstacles in front of you or what’s that like? Ha ha ha. No, I’m telling you what it’s like when you have some, thankfully it’s not me, but you know, it’s my wife, but it’s right, it’s, that’s what it feels like as the customer when you’re trying to go through this process.
Rob Mohr (10:09.711)
I don’t know. I don’t know if they’re doing that.
Melissa Brown (10:10.806)
Rob Mohr (10:21.409)
Yeah, well there’s, you know, think about the prior health process. There’s a lot of good reason for some of it. You know, you’re going to have drug A, but it makes more sense clinically that you try and drug B, C, and D first. And so there’s going to make you do steps to do that. Yeah, there could be cases where things get slowed down for the purpose of maybe.
Melissa Brown (10:33.899)
Melissa Brown (10:39.658)
Rob Mohr (10:42.377)
having people think about other options that might be cheaper, but for the most part, I think the process is working. I think if you think about what we’re replacing, the real pain was doing all this with fax and phone calls. Now, at least, we’re doing it where a large percentage of drugs that used to take a fax, the fax getting processed, looked at, entered, do not work, come back. Well, some drugs are just, if you supply me this information, we’re going to approve it. So it’s like bam, it’s approved.
Melissa Brown (10:54.922)
Rob Mohr (11:10.773)
Without the electronic transaction, that would have taken probably 48 hours or longer.
Melissa Brown (11:16.126)
Yeah, yeah, I think it used to take, yeah, I think it used to take on average like 30 days in the past to get, you know, a typical drug through the prior authorization process prior to the electronic means. So.
Kelly J Wendlandt (11:33.133)
Is there a lot of work left? Is this a mature area specialty drugs or do you think we’re on the front end of getting this process automated or halfway through? Or like, what’s your sense of where the process is?
Rob Mohr (11:46.273)
Yeah, I don’t know if I have insight of where we’re at as a whole. I just know that we’re, you know, a few years into the improvements, you know, like LodgeSaw has been touching it for, you know, five or 10 years. So it’s grown a lot within that time, but the EPA standard isn’t even that old. You know, we were involved in the
Melissa Brown (11:50.147)
Melissa Brown (12:10.446)
Rob Mohr (12:10.957)
And I’m trying to remember how many years ago that was.
Melissa Brown (12:14.359)
It’s less than 10 for sure.
Rob Mohr (12:16.129)
Yeah, so you think about it, it was all facts. And then what Mosa’s project is right now, it’s not the PA side, but it’s the compound drug side. They have up until right, still today, they have an exemption from the DEA that they can do fact scripts just because people are not handling compound drugs very well. The solution that Mosa’s team is implementing handles it in a structured, proper, certified way.
that a lot of VMRs can’t do today. So you think about that, so they’re still doing faxes until this solution’s out, which is crazy.
Kelly J Wendlandt (12:55.861)
I know we do work with private, you know, Fortune 500 and smaller, mid-size and smaller companies, and also with the state. We recently did one of the largest states in the country, a project for them. Was that part of the work we did at the state of Florida, or did we do specialty drug as part of what we did there or not?
Rob Mohr (13:15.558)
It wasn’t a specialty drug, it was a prescribing solution for a juvenile justice type of setting.
Kelly J Wendlandt (13:24.321)
Okay, okay, good. Well, Melissa Brown, Rob Moore, it’s always so great to see you. Thank you for your time, thank you for your expertise, and for everyone else out there, you are watching the vodcast. Yeah, thanks you guys.
Melissa Brown (13:38.986)