MS patients with Shields Health Solutions have $10 copay for care

Shields’ care model may help break barriers to treatment access in MS

Margarida Maia, PhD avatar

by Margarida Maia, PhD |

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People with multiple sclerosis (MS) in the U.S. who have access to a Shields Health Solutions care model pay an average $10 out of pocket each month for their MS treatments, according to the company — which noted that this amount is considerably less than the national average of more than $300 cited in a 2019 study.

Thanks to the use of an integrated specialty pharmacy, MS patients with Shields start taking their medications on time — on average within less than two days of getting the prescription — and report an average number of relapses that falls toward the lower end of the desired range, the company noted in a 2022 outcomes report.

“We are thrilled to reinforce our reputation as the nation’s leading specialty pharmacy partner through our exceptional outcomes in various complex disease states,” Brian S. Smith, chief pharmacy officer for Shields Health Solutions, said in a company press release.

“This continues to show Shields’ unwavering commitment to patients and their overall wellbeing,” Smith added.

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Rising MS Medication Costs Mean Some Patients Are Skipping Doses

Fewer relapses seen in patients with Shields Health Solutions

Specialty medications for complex diseases like MS can be expensive, and patients often have to cover a portion of these costs themselves, out of pocket, separate from insurance coverage.

On average, MS patients in the U.S. typically must pay more than $300 each month in out-of-pocket costs, including copay and deductible amounts, for their MS treatments.

In addition to high costs, other barriers can make it difficult for MS patients to get the care they need. For example, doctors and pharmacy teams sometimes do not coordinate their efforts well, which can limit access to specialty medications.

Shields, however, offers an integrated care model designed to break down these barriers to care with the goal of optimizing patient outcomes, according to the company’s specialty patient care model. The company says this model opens access to more than 90% of specialty medications to three times more patients, while reducing these individuals’ average out-of-pocket costs.

One example of the company’s services is the identification of financial assistance opportunities, which has led to an estimated reduction in spending of nearly $54 million in 2022, per the report.

Shields’ clinical team includes seven MS-certified specialists who help enhance care by providing support and education, and by optimizing treatments when challenges arise and treatment goals are not met.

One way Shields measures response to MS treatments is by monitoring the annualized relapse rate (ARR), or the average number of patient-reported flares in one year. Relapses refer to periods when new symptoms occur or old ones worsen.

“ARR is an indication of response to MS treatment as well as disease progression,” the company wrote in the report. “A lower ARR is optimal, with a range based on literature benchmarks (0.16 to 0.37).”

In 2022, the ARR among MS patients with access to Shields’ care model was 0.18, a value that falls toward the lower limit of clinical trial benchmarks.

Also, if a patient reports a relapse, Shields’ pharmacists will review the patient’s medical record to determine if the relapse could be due to medication-related issues, such as non-adherence. Pharmacists can step in to help address those medication issues and coordinate care with the healthcare provider to manage the relapse.

Overall, adherence to MS medications under Shields’ care model was 93%, meaning patients are receiving and taking their medications on time and as prescribed, and most patients (92%) reported feeling very well or well with how their specialty medication is helping them manage the disease, the company reported.