Getting The Right Dose of Factor: Why It’s Important to You and Your Insurance Company
Horizons in Hemophilia, August 2012
By Michelle Fitzwater, Managed Care Contract Specialist
Joe has mild hemophilia and does not have to infuse often. At his clinic visit, the hematologist gave Joe a prescription for 1500 units of factor to be used as needed. Joe had recently read a blog about an insurance company requiring a patient to stay within a certain percentage of the prescription and Joe had several questions for his doctor. Joe learned that clotting factor is manufactured in batches and each vial of factor can hold a slightly different number of units.
When the pharmacist fills the prescription, she calculates the number of units in the available vials of factor and determines how many vials of factor to send Joe so that his actual dose of factor most closely matches the dose prescribed by the physician. This process is called Assay Management.
The Hemophilia of Georgia pharmacy and Beacon Pharmacy use customized, award-winning computer software that assists the pharmacist in matching the prescribed dose. The pharmacies stock a complete range of factor products in different assays and use this software to dispense as close to the prescription as possible. As a result, the pharmacist is able to meet each patient’s specific needs and keep costs down. The pharmacist follows the recommendation from HoG’s Medical Advisory Committee and has the flexibility in the computer system to modify the range of the dose. Our goal is to dispense closest to your dose with the least number of vials to mix. Using the specialized software, the pharmacist will select combinations of vials from our inventory that come closest to your dose.
Hemophilia of Georgia and Beacon Pharmacy stock factor in all ranges available from the manufacturer. Most factors are available in the following ranges: 250, 500, 1000, and 2000u. Some even go up to 3000u vials. In non-emergency situations if the pharmacy is unable to reach the target range, additional assays are ordered for overnight delivery and a partial order is shipped to you. We communicate daily with the pharmaceutical companies to see what sizes are currently available in your prescribed product and we receive inventory from these companies daily.
So what does all of this mean for you? First it shows that we are committed to providing the very best pharmacy services to you. We want to ensure we can follow your doctor's prescription as closely as possible. New prescriptions list patient weights and the pharmacists inquire about weight if it is not included. Growing children usually are seen at the HTC every 6 months and new weights are recorded. Clotting factor doses are based on weight; as your child grows any fluctuations in weight should be reported.
This also means we are saving you and your insurance company money. Just as factor is prescribed and dispensed per unit, it is also billed per unit. When we get your dose closer to your prescription, you don’t pay for extra factor that you don’t really need.