Guided by their commitment to patient access to care, Doylestown, Pennsylvania-based OrthogenRx, Inc., a medical device company focused on the development and commercialization of treatments for knee pain caused by osteoarthritis (OA), has launched new pricing options relating to its TriVisc Direct Purchase Program and TriVisc Patient Assistance Program.
TriVisc is an intra-articular injection of sodium hyaluronate that is indicated for patients who have found no relief from knee OA pain using other non-operative therapies. It is one of a class of products known as hyaluronic acid (HA) or viscosupplements that are used to improve the lubricating ability of the OA knee and alleviate pain.
“At least 15 million people have lost their health insurance during this pandemic,” said Michael Daley, Ph.D., co-president, co-CEO, and founder of OrthogenRx, Inc. to OTW. “En masse, patients are postponing their surgeries and are desperate for non-operative pain management. Now more than ever those suffering from knee OA pain need alternative options to pay for their treatment.”
Ashley Wohl, vice president of marketing at OrthogenRx, told OTW, “The healthcare reimbursement landscape is always evolving and we continually strive to listen to the voice of customers as they are a critical to our understanding of the challenges they face. As a small company, we are accustomed to being able to shift with the times when changes negatively impact patients…every year we anticipate market disruption of some sort.”
And listen, OrthogenRx did…
“Customers have conveyed that they are frustrated by commercial insurance denials, not only for OrthogenRx products, but for the class of products known as intra-articular hyaluronic acid,” said Wohl. “Patients with commercial coverage are finding it difficult to find access to intra-articular hyaluronic acid therapies.”
“One year a product may be covered and the next year it may not be. If a patient is denied coverage for a therapy then there are often obstacles and paperwork to obtain prior authorization. As a company, we know that over 30% of private insurance companies will not cover members who may need intra-articular hyaluronic acid. Even if someone has commercial coverage, the insurer will often deny access to this minimally invasive, safe and often effective technique.”
The solution? The TriVisc Direct Purchase Program and the TriVisc Patient Assistance Program.
Living Their Values, Doing Their Part
Because so-called “elective” knee surgeries have been canceled or delayed, the demand for intra-arrticular knee injections has increased significantly. According to Daley, “We could see that the need for these programs was only going to increase as more patients were negatively impacted. The TriVisc Direct Purchase Program enables patients to purchase product directly through an exclusive network of pharmacy partners, at a fair and consistent price.“
Ashley Wohl told OTW, “The OrthogenRx Direct Purchase Program provides a convenient solution to underinsured patients. The patient’s healthcare provider submits a benefit investigation request to the OrthogenRx reimbursement portal. A benefit investigation confirms a patient’s eligibility, meaning there is not a covered insurance benefit. For a patient who does not have an insurance benefit, patients are able to purchase product directly through an exclusive network of pharmacy partners. TriVisc is shipped directly to the healthcare provider’s office at price that is approximately 75% less than retail pharmacy costs.”
Wohl continued, “We have made a commitment to patients, and we believe that healthcare is a shared responsibility between payers, industry, and healthcare professionals. This is particularly important given the extensive delays in elective surgery that are accompanying COVID-19. TriVisc is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and alleviate OA knee pain. TriVisc is safe for a repeat injection series if needed. It is important that clinicians and patients consider non-operative, conservative treatment options to manage conditions and symptoms during the pandemic.”
Dr. Daley: “We founded this company in order to create a more efficient way of delivering healthcare. We don’t have massive overhead like many of our competitors…we can basically give away product or provide significant discounts when necessary and take the financial hit. Insurers are always looking for ways to eliminate costs, which is rather short-sighted on their part.”
“If the cost to the insurer is $150 per syringe and they say, ‘Give them some acetaminophen instead,’ well that can expose the patient to additional health hazards, and specifically for chronic OA knee pain has been reported often to be ineffective. In addition, because the treatment is delivered locally, one doesn’t have to worry about potential interactions with other systemic medications. Personally, I’ve received over 36 injections of HA between my two knees over an eight-year period and found them very beneficial.”
The TriVisc formulation is approved in 63 countries outside the U.S., with over 35 million doses administered worldwide to date.
What is the costs for knee injections? My insurance won’t cover.
Thank you,
Patricia
I have tried steriod injections to no avail and now would like to try gel injections for my knee. My insurance has denied this. How much do these shots cost and how does your program work?