Specialty-Program Designer
High-cost and specialty-therapy access — eligibility, hub coordination, patient-access economics.
Program canvas
SP-0057 · Vireo Biosciences · Rare Disease
Eligibility criteria
Genetic-confirmed diagnosis; age ≥ 12; prior line-of-therapy exhausted; hub-verified insurance benefit.
Hub coordination
Accredo primary hub · CVS Specialty secondary · manufacturer copay and PA support integrated.
Specialty-pharmacy network
Accredo, CVS Specialty, Optum Specialty — dispensing rules aligned with payer channel.
Patient-access economics
List price $412K/year · covered lives 71% · projected first-year uptake +34%.
Economics — modeled first-year uptake
Founder benchmark line: 21% first-year growth
Reference: 38% new-customer-base growth
Access-economics summary
First-year uptake modeled at +34%, above the founder's documented 21% benchmark; new-customer-base growth tracks 38% reference under current hub coordination.
Eligibility logic
- 1. Genetic-confirmed diagnosis (positive)
- 2. Age ≥ 12 (positive)
- 3. Prior line-of-therapy exhausted (positive)
- 4. Hub-verified insurance benefit (positive)
- → Eligible for program enrollment
All specialty programs
| Program ID | Sponsor | Therapy | Hub Partner | Eligibility Model | Projected Uptake | Status |
|---|---|---|---|---|---|---|
| SP-0057 | Vireo Biosciences | Rare Disease | Accredo | Genetic-confirmed | +34% modeled | Active |
| SP-0049 | Halcyon Oncology | Oncology | CVS Specialty | Line-of-therapy | +22% modeled | Draft |
| SP-0044 | Solstice Rare | Rare Disease | Optum Specialty | Genetic-confirmed | +28% modeled | Active |
| SP-0038 | Peninsula Immunology | Immunology | Accredo | Biomarker-positive | +19% modeled | Active |