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Nurse-led Medication Management

asian call centre nurse

Benefitting patients and sponsors

High-cost specialty medications have challenged insurers to balance patients' needs for effective treatment with long-term plan sustainability, and the cost management needs of plan sponsors. We address this challenge by offering plan sponsors a Nurse-led Medication Management program designed to monitor and manage patient treatment plans while helping to achieve better and more cost-effective health outcomes.
I don’t just appreciate the people that care for me. I love them for doing so.

- Rheumatoid Arthritis patient

Measurably improving patient outcomes

A recent health economic outcome research study of Canadian patients performed by HealthForward demonstrated that, compared to routine care alone, Nurse-led Medication Management improved quality of life and health outcomes in rheumatoid arthritis and psoriatic arthritis patients treated with biologics: 

84% of patients experienced improved quality of life scores

Versus 62% on routine care alone 

46% of patients experienced remission of their disease

Versus 13% on routine care alone

54% of patients experienced lower disease activity

Versus 28% on routine care alone 

nurse at laptop with business man standing behind

What is Nurse-led Medication Management?

nurse at laptop with business man standing behind
Nurse case managers ensure patients are taking the right drug; are adhering to their prescribed treatment; fully understand their treatment plan and the expected results; and have access to support, education, and the assistance they need. Our nurse case managers advocate and interface between the patient and individuals in their circle of care, including their physician, their insurance payer, their family, pharmacy, and any manufacturer-sponsored Patient Support Programs (PSPs). If the patient is not benefitting from their medication, the nurse case manager will work to understand treatment options available with a goal to find a more effective medication.

nurse at laptop with business man standing behind

How do patients benefit?

A nurse case manager champions the comprehensive support and access to effective treatment required to achieve better health outcomes. They communicate with physicians and payers to ensure patients have access to the right medication as quickly as possible. Patients develop trusting relationships through the support they receive from their nurse case manager, who stays with them throughout their treatment journey. More frequent monitoring supports patient adherence to treatment, which is linked to improved health outcomes.
female patient reviewing files with female doctor
notes at meeting

Why should insurers consider Medication Management for their plan sponsors?

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Plan sponsors offer group benefits so their employees can continue to work productively, while relying on insurers to manage their benefit costs. Nurse-led Medication Management affords plan sponsors the assurance that their members are on the right medication, and will benefit from the treatment provided, without incurring unnecessary costs. The ability to collect objective health-outcomes data through a Medication Management program also enables ongoing program evaluation and decision-making. With years of experience, the evidence has validated the vision: Nurse-led Medication Management has ensured that patients have access to the right medication as quickly as possible, resulting in improved quality of life, health outcomes, and a positive impact on the workplace.
notes at meeting
My old medication was making me overeat and I contemplated going on disability. The case management process helped me find a better medication. After 5 months I am back in the gym, and I’ve lost over 60 pounds. My diet has changed drastically, and I’m feeling great!

- Ankylosing Spondylitis patient