Patients at the Center of the System: Coffee and a Chat with CoverMyMeds’ Perry Lewis and Patient Advocate, Melissa Paige

CoverMyMeds’ Vice President of Industry Relations, Perry Lewis, had the privilege recently of sitting down to talk with Melissa Paige, Pharmacy Patient Medication Access Principal Coordinator at the University of Virginia Health System. Melissa also serves on the CoverMyMeds advisory board for the 2018 Real-Time Benefit Check National Adoption Scorecard, so we knew ahead of time she’d be a stellar person with whom to connect.

Perry and Melissa shared a pot of coffee and conversation, and once the topic of patients came up, the conversation was flowing and the coffee went cold. Take a peek at their chat. Once you do, we’re certain you’ll agree that patient advocates should pretty much always wear capes.

Perry Lewis: I’m so happy to finally be sitting down with you, Melissa! You’ve been a revered member of the advisory board for the Real-Time Benefit Check National Adoption Scorecard and a great asset to the team. A passion for patient care is something you and I really align on, and I appreciate your understanding of the need for industry visibility into what patients truly need. What brought you down your current career path? 

Melissa Paige: Thanks, Perry! It’s pleasure to work with the CoverMyMeds team and lend my voice to the scorecard.

Fifteen-years ago, I got my CPhT license as a ‘backup’, while going to college, but it laid the foundation for my career. I worked in many positions over the years from retail, infusion, hospice, mail order and hospital. I eventually worked in the pharmacy of two large Military Treatment Facilities (MTF), where I gained empathy and compassion for patients that have sacrificed so much.

The real change started nearly a decade ago, when I applied for a pharmacy tech position at the University of Virginia Health System and went to work on the pharmacy assistance team. I had no idea what was entailed, they only said “You get told ‘no’ a lot and it’s your job to find solutions and make it a ‘yes’, to help our patients receive their medication.” I was sold.

PL: That had to be quite the adventure!

MP: It was! The first week in the office I was completely overwhelmed, trying to figure out how to triage when everything was urgent. I knew the paper system couldn’t continue, it wasn’t what was best for the patient. So, we figured out a way to digitize the info.

The second major career change happened when I was offered to take on patient assistance in the cancer center.

I love where my role in health care has landed. Being told “it can’t be done” or “there is no solution” is what drives me to advocate harder for the patient. There is always a way. I challenge those phrases by exhausting every resource available to finding solutions which includes leveraging the manufacturer support programs.

PL: That’s really impressive. I’ve had the privilege in my career of sharing my own family’s story on our journey to being healthy, the highs and the lows, and I know that is what really drives me to do the work I do every day.

MP: I feel the same way! My father was diagnosed with Leiomyosarcoma and I watched my mother try to navigate the complex system and try to keep a strong spirit for our family. I awoke one night to hear her crying over medical bills. A couple years later, I watched her advocate for my youngest brother who was diagnosed with Duchenne Muscular Dystrophy. Navigating our own health care journey as a family was an emotional struggle. My mother did not have the knowledge, resources or a health care advocate on her side to help and I’m determined to be that person for patients who are currently struggling.

PL: Thank you for sharing your story. It is indeed a complex system and finding solutions for patients and their families, especially when navigating complex specialty medications, is a passion we share. That being said, what do you think is the most frustrating aspect of health care today that has changed over the last 50 years or so?

MP: From the patient’s point of view, the lack of transparency of patient responsibility, meaning out-of-pocket cost, is the most frustrating and a huge cause of anxiety.

As the patient advocate, this lack of transparency on their behalf can be frustrating. The work to get our patients on treatment is time consuming and difficult. I remember being a pharmacy tech at a retail pharmacy when Medicare D rolled out. At the time, I didn’t see too much financial distress as I was mainly dealing with primary care. Now that I’m in an area where most of the medications are specialty, we run into financial distress on nearly every patient.

These are all problems in which we can stand behind our patients and guide them best we can, and point providers toward technology like real-time benefit check, that can help.

PL: Well said. Speaking for myself, working for a health care IT company, it’s so important that we stay as up to date as possible on what the true “headaches” are for patients when it comes to getting access to these medications and continue to innovate based on that. As patient advocates, what can we be doing to ensure a better experience for the patient across the board?

MP: The best thing we can do is develop meaningful and progressive teams that alleviate internal roadblocks (health care facilities specifically), learn to navigate patient access landscape and always advocate for the patient. An advocate should take as much of the burden off the patient and their family as possible, while still keeping them involved, educating them and empowering them to advocate for themselves as well.

Allowing our health care provider teams to focus on the clinical management of the patient is the goal for our team. The touch-points on getting a clearer understanding if a patient will be able to start treatment is something we have learned over time, and with more electronic solutions, access navigation is getting easier.

PL: How do you feel those electronic solutions such as, electronic prior authorization and real-time benefit check, (or really any HIT solution) can help ensure patients get the meds they need?

MP: Providers should understand that prior authorization and real-time benefit check at the point of prescribing are going to help overcome many barriers we face. Getting closer to the actual cost of a therapy and instant access to all eligible services available (patient assistance programs, copay, starter kits, etc.) will be the biggest game changer for our patients.

When you have the patient in front of you, all you want to do is to help alleviate any stress they have around access to treatment. I’m excited for what is to come as well as the current initiatives.

I highly suggest patient advocates get involved and give real-world feedback to the companies that are trying to bring new innovative solutions to the health care industry. We can’t just expect others to design standards and build quality solutions if we are not involved. Listening to the customers voice, and always keeping the patient first, is crucial for producing an electronic medical ecosystem with widespread adoption.

PL: Thank you so much for sharing your thoughts and journey, Melissa! We’ll see you out there!