Holistic Approach to Cystic Fibrosis Care | Personalized Member Support - Prime Therapeutics
Help your members living with cystic fibrosis
Learn more about cystic fibrosis
Cystic fibrosis is a progressive, genetic multiorgan involvement disease that causes persistent lung infections and limits the ability to breathe over time. Cystic fibrosis is an inherited disease and often diagnosed at birth. There are close to 40,000 children and adults living with cystic fibrosis in the United States.1 As with many conditions, living with cystic fibrosis can be costly. In fact, nearly 50% of people with cystic fibrosis have had to delay or forego care altogether.2
Oral cystic fibrosis transmembrane conductance regulator (CFTR) modulator drugs, designed to increase or potentially restore the function of the CFTR protein by targeting specific disease-causing CFTR mutations, have revolutionized cystic fibrosis care, dramatically reducing cystic fibrosis hospitalizations and lung infections. However, these drugs cost more than $350,000 annually.3
1 in 10,000
1 in 10,000 of Prime’s commercially insured members had a CFTR claim in the past quarter.4
See how Prime can help
Prime’s real-world CFTR drug treatment cost offset and value assessment found reductions in medical care costs after CFTR drug therapy initiation. However, due to the extremely high CFTR drug cost, there was a negative 9:1 return on investment. At this high drug cost investment, it’s essential that members adhere to therapy to get medical benefits. And it’s important to target the lowest-cost drug delivery channel with the highest-quality care.4
9
Cystic fibrosis drug therapy is the ninth most expensive drug category based on Prime’s combined commercial medical and pharmacy claims data.4
A comprehensive approach to savings
Proactive education
Gain peace of mind that providers, pharmacies and cystic fibrosis specialists have received education on your program policies and goals prior to launch.
Improved member experience
Connect members with an integrated cystic fibrosis treatment center specialty pharmacy and a care team who helps drive adherence and prevent drug waste.
Data integration & intervention
Clinical reporting and medical, pharmacy and member data improve adherence and recommend lower-cost opportunities where available.
Choose what works best for you and your members
Footnotes
*All brand names are property of their respective owners.
**The programs listed are not available to all clients. Please check with your representative if you are interested in learning more.
1 About cystic fibrosis. (n.d.). Cystic Fibrosis Foundation. https://www.cff.org/intro-cf/about-cystic-fibrosis
2 The importance of cost and affordability for people with CF. (n.d.). Cystic Fibrosis Foundation. https://www.cff.org/about-us/importance-cost-and-affordability-people-cf
3 Marshall, L. Z., Espinosa, R., Starner, C. I., & Gleason, P. P. (2023). Real-world outcomes and direct care cost before and after elexacaftor/tezacaftor/ivacaftor initiation in commercially insured members with cystic fibrosis. Journal of Managed Care & Specialty Pharmacy, 29(6), 599–606. https://doi.org/10.18553/jmcp.2023.29.6.599
4 Internal analysis, 2024