Evolving Patient Access Programs for Specialty Therapies

When a physician prescribes or treats a patient with your specialty drug, the stakes are high for everyone. Patient access is evolving to improve the patient and physician journey with specialty therapies


(Sponsored by RxCrossroads by McKesson)

When a physician prescribes or treats a patient with your specialty drug, the stakes are high for everyone. Patient access is evolving to improve the patient and physician journey with specialty therapies.

Patient access services are critical to the success of your biopharma company’s specialty therapies and today, too few patients are gaining access to the human touch and assistance that hub programs provide.

The challenge with hub programs
Traditional hub programs are used to facilitate enrollment into specialty patient access services. Many of today’s hub programs typically offer a mix of services, which could include:

* Program enrollment
* Financial needs assessment
* Prior authorization support
* Access to adherence programs, including health coaching and education
* Financial assistance, including medical and pharmacy co-pay assistance
* Access to patient assistance programs (free goods)
* Clinical and behavioral support services

The issue is that hub programs are dependent on providers and patients to enroll in these services and each program has a different form, different requirements, and different method of engagement. At the core of hub services, trained staff are performing most of these services manually, once patient consent is obtained. As a result, the services can take significant time to complete as part of a complex process and therefore often be underutilized by patients.

The reality is that your biopharma company likely customizes the services you want to offer patients. That means you have a set of services for each drug. Physicians who prescribe multiple specialty therapies try to juggle different sets of services and requirements for each drug. And patients who are on two or more drugs—or who switch medications—have a variety of requirements in support of initiating each new therapy. This growing complexity and variability create a problem. Having multiple sets of manual, inconsistent and inefficient patient access services creates confusion and extra work in the already busy provider offices. It offers too many chances for prescribers and patients to bypass your services or to discontinue them after they start. When that happens, and it happens too often, no one benefits. Not you. Not the physician. And most importantly, not the patient.

Bringing patient access services closer to the patient
Solving for these complexities means simplifying the journey for patients and providers, making it easier for them to learn about, enroll in, and participate fully with patient access services. One way RxCrossroads by McKesson is doing that is through digital engagement. Together with our partner CoverMyMeds, we’ve evolving our hub services to include a solution that focuses on leveraging digital automation in provider workflow while still incorporating human touch throughout the journey to provide personalized support when and where it is most needed. The platform is called AMP: Access for More Patients™ (AMP) and it combines technology and skilled patient and provider support to three things:

  1. Automate the available patient access services available through the platform while offering a human touch/personalized support where and when it is needed, helping to increase speed-to-therapy for patients.
  2. Utilize a single portal through which physicians can manage and communicate with the hub across their patients’ continuum of care, streamlining the providers view and simplifying their access requirements.
  3. Create a single viewpoint through which patients can access patient services that they need for all their specialty drugs, simplifying and easing their journey.

The new platform is automated, standardized and cloud-based with connected caring case managers to take on any reimbursement and access challenges that patients or providers encounter. AMP takes accessing hub services from a fragmented process and transforms it into a consolidated and seamless one. It allows users to access the platform from any device at any time and becomes the single source of truth for all drugs prescribed by a provider to all the provider’s patients along their entire continuum of care.

New solution, new capabilities
Let’s look at a few examples of the new capabilities that a next-generation patient access platform can provide you, your prescribers and patients.

One of the most important elements that it would give you is visibility into the patient journey, starting at the point of prescribing. As providers and patients interact with the platform, the platform is capturing data points critical to the successful commercialization of your specialty therapy. For example:

* Did the physician prescribe or order the infusion of the drug?
* Did the patient’s healthcare plan cover the drug?
* If so, how much did the healthcare plan cover?
* Did the patient need financial assistance?
* How much financial assistance did the patient need?
* Did a specialty pharmacy dispense the drug?
* What support services were offered and used by the patient, and when?
* Did the patient refill the drug?

Leveraging these specific insights can be invaluable to understanding the success and challenges faced by providers and patients throughout their journey.

Empowering physicians and patients
By combining technology and live support, AMP offers prescribers the ability to view their entire patient case load and understand each patient’s individualized access experience with a new specialty therapy. AMP helps the physicians to break down administrative barriers that may be preventing patients accessing therapy in a consolidated way not seen before. For example, AMP can offer automated prior authorizations and follow up, reducing that task time from days or weeks to minutes or hours.

For patients, AMP combines the best of personal interaction and superior in the workflow technology for providers, reducing the patient and provider stress of therapy starts. AMP enables providers and patients to more effectively navigate reimbursement complexities and process to access novel therapy in reduced time.

Specialty medications are more expensive and more challenging to administer than traditional therapies and they may require special handling – cold chain distribution. Physicians may need to infuse the products direct and this may require a test or a procedure upfront and continuous monitoring for side effects. On top of that, it’s likely that the patients are seriously ill. So the psychosocial effects of having a serious disease compound everything. It can put strain on employment and impact insurance over time. Every patient’s journey can be unique.

AMP allows patients to access the service support they need when they need it. It allows trained case managers to focus on meeting the challenging needs for patients with access needs and allow providers to focus on appropriate clinical care. Case managers’ discussions are critical to patients when there is a lack of insurance or high copays; these crucial conversations can range from explanation of financial assistance options to nurses providing support on self-injection, or assistance finding transportation to a medical appointment.

Benefits of technology-forward patient access
The capabilities described provide all stakeholders—your biopharma company, prescribers and patients—a number of benefits.

Let’s start with you. How would you benefit from having visibility into the patient journey with your drug and collecting data from each step along that journey? From a business standpoint, you would know:

* Clinical prescribing behavior including titration, dosing, and other patient therapy start data
* Visibility into the real time access needs and challenges of your patient population
* Visibility into payer prior authorization requirements and challenges
* Insights into physicians’ prescribing practices such as when they prescribe a drug and when and why they switch patients to another drug

For physicians, it’s about simplifying the entire process of prescribing specialty therapies and managing care. Physicians and their office staff spend less time on paperwork and interacting with insurers. Through AMP, providers see results quickly and therefore it reinforces a positive experience. As a result, they enroll more of their patient population to AMP patient access services. They spend more time on direct patient care, whether that’s treating patients, talking to them or directing them to the appropriate access services.

Boosting adherence and outcomes
For patients, it’s all about speed to therapy, affordability, adherence, and clinical outcomes. AMP’s capabilities mean that patients are informed about the access process along the way and can stay involved in the process. This involvement helps to reassure patients that their needs are being met. This in turn, reduces barriers to adherence, whether those barriers are financial, clinical or logistical. AMP means access for more patients. With AMP, more patients get on their prescribed drug therapies. Patients start their therapies faster. Patients stay on their therapy longer, and do not experience unnecessary gaps in treatment. The results are better clinical outcomes and improved health.

Given the high clinical and financial stakes that specialty drugs represent for all involved, you need a sophisticated patient access approach—one that provides stakeholders the support that they need to help patients get the most from your life-changing drug therapy. The solution is here–AMP.