HFA STATEMENT OF POSITION
Background
Single source provider contracts allow a single company to provide clotting factor concentrate and ancillary services to patients. Single source provider arrangements have the potential to reduce access to services, multiple providers and clotting factor. Consumers can be forced to endure delays, disruption, or inadequate care without recourse or freedom to choose an alternative provider.
Single source provider arrangements compromise the lives and livelihood of a vulnerable population already burdened by a high cost and chronic illness. Loss of a range of service providers can also be costly. Lack of adequate support will result in time lost from work or school, the ability to maintain employment and an increase in development of hemophilia related complications for many patients. Furthermore, single source provider contracts:
- Limit choice of service providers
- Can prevent access to the full range of products
- Cause difficulty for consumers in rural areas receiving service and product
Issue
A person with a bleeding disorder requires appropriate time and attention to help manage a chronic, high-cost disease. When faced with substandard service in a single source provider arrangement, the person is exposed to significant challenges particularly if there is no standard of service document in place. In order to maximize savings decision-makers often seek to curtail the range of factor products and assay levels available to people with hemophilia and bleeding disorders. Fewer choices and few available products almost always means that the bleeding disorders community is left with poorer treatment options.
Increasingly state health agencies are forced to reduce costs through elimination of multiple providers of clotting factor and service. We recognize that the impending economic crisis has forced most states to operate under strict budgetary guidelines. Nonetheless, short term cost savings plans such as a reduction in the number of service providers will not realize cost savings, particularly if the provider is unfamiliar with bleeding disorders. Conversely, unfamiliarity results in higher cost and detrimental health outcomes.
Position
HFA opposes any plan that will implement a single source provider program for clotting factor concentrates. Any “one provider serves all” approach to the treatment and service of the bleeding disorders community is inefficient and potentially harmful to our community.
States that seek to capture cost savings relative to hemophilia and bleeding disorders do so most often by limiting product choice, assay size or both. No single product will adequately treat the multitude of factor deficiencies and bleeding disorders. As such it is a matter of medical necessity that the fullest range of product possible is made available to consumers through multiple providers.
The solicitation and implementation of single source provider contracts by various payors jeopardizes continued access to care for the bleeding disorders community throughout the United States. The Hemophilia Federation of America emphatically urges the complete rejection of single source provider programs and similar arrangements.
