Making the Most of Every Opportunity

Leslie Vaughan leads the Nufactor, Inc. division of FFF Enterprises with a wealth of financial, operational, reimbursement and clinical management experience. Leslie’s business background includes corporate and field level operational management, P&L management, budget development, business development, clinical program development and policy and procedure development and maintenance. Leslie has a proven record of business growth and capturing cost reduction through effective sales management, process design and performance management. Prior to joining FFF Enterprises in 2012, Leslie served as Senior Vice President, Chronic Therapy Division at Crescent Healthcare in Anaheim, Calif., where she was responsible for specialty pharmacy business.

Leslie holds a Bachelor of Science and a Pharmacy degree from the University of New Mexico, Albuquerque, N.M., and is licensed as a pharmacist in 31 states. Leslie lives in Southern California.

BSTQ: NuFactor celebrates its 30^th anniversary this year. What sets NuFactor apart? What gives it staying power and makes it special?

Vaughan: What sets Nufactor apart are the people who choose to be part of our organization. We have a team fully dedicated to ensuring we provide the best possible care to every patient referred to us.  I think of all the steps in the process to make sure we can provide for patients — contracting with payers, sales team calling on physicians, intake and reauthorization, nursing, pharmacy, patient care coordination, warehouse, reimbursement and administrative support — and I can remember many examples of individuals within each department going out of their way to provide something special to make a difference for a specific patient. This mindset of “patient first” is embedded throughout the team.

BSTQ: What led you to join NuFactor?

Vaughan: I joined Nufactor at an interesting point in my career. I was working for a regional provider with a strong focus on quality clinical care. That company was acquired by a very large company that didn’t have the same high-level commitment to patient care. At the same time, I learned our CEO, Patrick Schmidt, was committed to investing in a study to help identify prescribing habits for immune globulin (IG) therapies. This study had no guarantees of bringing revenue or patients to Nufactor, but Patrick supported the financial backing of the study anyway, knowing it was the right thing to do for the industry. I was lucky to join the company to lead the development and implementation of the study, which ultimately yielded very important information that helps us understand diagnostic and treatment approaches for many neuromuscular conditions.

BSTQ: Parent company FFF Enterprises’ motto is “helping healthcare care.” As a subsidiary of FFF, how does NuFactor align with that goal?

Vaughan: The “patient first” mentality is a key component of “helping healthcare care.” In some situations, a patient referred to us may not be able to receive services due to insurance carveouts. In these situations, our team doesn’t just tell the patient and prescriber “no.” We work with them to ensure the patient is transferred to a pharmacy that is in network for them and follow the case to acceptance by the new pharmacy. That is just one example of how our team helps healthcare care. The whole team is devoted to ensuring a patient obtains necessary therapies ordered for them.

BSTQ: The healthcare industry is changing, and it’s changing fast. What excites you about the changes, and what (if anything) worries you about them?

Vaughan: There are so many new technologies focused on healthcare, including automation and AI. These are both exciting and worrisome at the same time. Nufactor is integrating some automation and AI into our current processes, which will allow us to continue to scale by having automated processes complete some of the repetitive tasks we perform manually today. There are also many new therapeutic options coming to market that are exciting.

The most worrisome trend for me in healthcare is the growing challenges with obtaining prior authorization and appropriate reimbursement for the lifesaving therapies we provide. Currently, we see a trend of the cost of therapy increasing (medication cost, labor cost, etc.) and the reimbursement offered by insurance companies decreasing. This “squeezing” puts many pharmacies in difficult positions when determining what new therapeutic offerings they may add to their portfolio.

BSTQ: What are current trends in infusion therapy?

Vaughan: Expansion of stand-alone infusion centers managed by a nurse practitioner continues to be a growing trend. Other trends include insurance companies implementing “site of care” programs for multiple therapies in efforts to have patients cared for in the least costly site of care.

BSTQ: How has the shift toward more personalized, home-centric treatment models transformed specialty infusion?

Vaughan: As above, specialty pharmacy and specialty infusion continue to be a key focus for insurance companies to take advantage of care in a lower-cost alternative. For most patients, receiving care in their home is preferred and a safe option. Receiving infusion care in the comfort of your own home can increase adherence with therapy and improve outcomes.

BSTQ: Let’s talk about the supply chain. A significant disruption in plasma supply occurred worldwide during the past few years. Has the industry recovered? How is Nufactor dealing with the challenge?

Vaughan: As it seems now, the disruption in plasma supply has been corrected and plasma-derived products are readily available. Nufactor is fortunate to have strong relationships with our manufacturer partners, and we were able to weather the recent shortages without major impacts to providing care for our patients. Many manufacturers continue to research new technology to improve “yields,” so the same liter of donated plasma produces more IG than previous technologies allowed. I am hopeful this continued technological development can minimize shortage situations in the future.

BSTQ: The IG market has experienced significant growth over the past few years. What is driving this growth, and how can the industry best adapt to meet the increasing need?

Vaughan: IG is really a unique medication. It has been shown to be effective in treating many conditions with many different causes. In many cases, when a patient has tried and failed other first-line therapies, IG is the “go to” for prescribers to try to find a solution for their patients. Continued research into the use of IG in additional autoimmune conditions can yield additional U.S. Food and Drug Administration (FDA)-approved indications for use. With improved yields, as discussed above, there may be continued improvements in the supply chain to help support the increasing need.

In addition, it is important to consider dose modifications on an individual patient basis to find the lowest effective dose to control their condition. In many cases, FDA-indicated dosing is assumed to be the only dose that may work, but we have found lower doses often provide the same disease management as higher FDA-indicated doses.

BSTQ: 2025 is a big year for biosimilars. How has the ongoing roll out affected NuFactor?

Vaughan: Biosimilars have great potential. Unfortunately, there seems to be a bit of a misalignment between cost offered by manufacturers and reimbursement offered by payers, which can make offering biosimilars a challenge. We continue to work with both manufacturers and payers to close the gap and obtain reimbursement above our cost to procure the biosimilar product.

BSTQ: AI has arrived. Do you see this as a disruption to or a benefit for the specialty infusion space? Why?

Vaughan: I think AI has potential to benefit the specialty infusion space. Infusion is a complex therapy to navigate and requires many steps to get a patient serviced from referral to reimbursement collection. Many of these steps are repetitive, which allows potential for AI. For example, using AI to “read” a referral and do initial data entry into the electronic medical record is a work in progress for Nufactor. Having AI perform the data entry with a human check for accuracy allows our team members more time to focus on more complicated aspects of managing the referral rather than spending time on data entry.

I do think the “jury is out” on how well AI will work in assessing and managing clinical aspects of patient care. We have noted the use of AI in the prior approval process and, so far, AI has not been great at reading and interpreting clinical information, resulting in unintended therapy denials necessitating time-consuming appeals. I was pleased to see some recent efforts by the U.S. Department of Health and Human Services and the insurance community to meet to address improvements to the overall prior authorization process. Major changes aren’t expected until 2027, but we will be closely monitoring the project.

BSTQ: How is NuFactor helping lead the way in the specialty infusion space?

Vaughan: With a strong focus on excellence in patient care and adoption of new technologies, Nufactor stands to continue to have excellent performance.

BSTQ: Where do you see NuFactor in five years? Ten years? Beyond?

Vaughan: One of Nufactor’s strengths is our dedication to the best quality care for the services we provide. For continued growth, we are evaluating additional therapeutic areas to add to our portfolio. As we expand our portfolio, I expect continued growth while maintaining our status as the best provider of patient care for the therapies we provide. That being said, I do see Nufactor providing additional therapies in the next five to 10 years. One thing that won’t change is our dedication to maintaining a high standard of excellence to provide unparalleled patient care.