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Digital innovation is at the forefront of pharma strategy more than ever before as marketers strive to simplify the prescribing process of specialty medications. One way they are simplifying this process is by meeting healthcare providers (HCPs) within their workflow to streamline and facilitate patients’ access to life-changing medications. But what does digital innovation mean and how is it changing the way that pharma is interacting with HCPs and patients?
While specialty drugs account for only 2.2% of total prescription volume in the US, they accounted for over 45% of total pharmacy spend, or $218.6 billion in 2019.1,2 The cost of the increasing use of specialty medications has exposed unique barriers within the prescription and patient access process. Manufacturers have support programs that provide much-needed services for prescription medication access, affordability, and adherence. However, a recent survey of 10,000 patients across multiple therapeutic areas found that only 20% of patients were aware of such programs.3 Although doctors and their staff can assist patients with enrollment into these programs, the enrollment process is often time-consuming and fragmented, and doctors remain dissatisfied with current patient support options available. In addition, it’s estimated that over 90% of patient enrollment for specialty medications is still done via fax,4 making the process more time-consuming and creating yet another barrier to enrollment.
Digitizing access tools helps create solutions to this conundrum by not only raising greater awareness of pharma support programs at the point of care but also streamlining enrollment. Automating these tools within the EHR system reduces friction in the prescribing process by integrating the tools into the HCP’s workflow, reducing the burden of extra steps that add time in front of the computer and away from the patient. It also reduces mistakes that are commonly made during the manual enrollment processes, ultimately improving patient access, speed to therapy, and ensuring timely activation of affordability programs. These tools are often overlayed on top of the current patient support hub infrastructure already established. That means that rather than replacing the personal connection to patients in need of human touch, the streamlining of these processes puts the attention back on patients.
Getting patients access to therapy begins with HCP engagement. Here, we explore three steps to engaging HCPs to improve brand access and retention with digital point of care and sale technologies to improve patient access and enable speed to therapy.
At least 89% of office-based physicians use the EHR on a regular basis.5 EHR adoption has also increased among specialty HCPs.6 For example, according to a National Electronic Health Records Adoption Survey, 95.6% of office-based cardiologists, 94.5% of office-based neurologists, and 94% of urologists use the EHR. This means increased opportunities for pharma manufacturers to engage with HCPs.
However, traditional tactics are still leaving a gap in HCP and patient awareness, which makes increasing reach to HCPs within the EHR critical. While people rely on their doctors to obtain information about patient support services, only 3% of eligible patients actively use patient support programs, and nearly 60% are not aware of patient support programs available to them. Meanwhile, 80% of pharmaceutical manufacturers rely on HCPs’ to share information about support programs with their patients, but less than 50% of HCPs are aware of these programs or how to access them. Pharmaceutical representatives have traditionally been a top source of information for HCPs but the primary message is the product, and the access message is secondary, with HCPs reporting that they hear about access services in less than one of four rep calls.
Additionally, COVID restrictions that further limited face-to-face interactions with providers, also worked as a catalyst for the consolidation of offices into health systems and a more permanent shift towards digital communication solutions and strategies. This digital shift has pushed pharma marketers to find more efficient ways to supplement their efforts and fill the information void with new digital strategies within the HCPs’ workflow.
As a result, the EHR has emerged as an invaluable resource for pharma and biotech manufacturers to communicate with HCPs throughout their prescribing journey. Visualize the following scenario: a migraine patient sitting in front of their HCP during a follow-up visit to check progress and possible treatment options. While the HCP logs into their EHR there are algorithms working in the background piecing together data from the patient’s journey so far. As the visit progresses, the HCP starts seeing messaging for a migraine therapy. As the HCP moves forward to identify relevant ICD-10 codes they receive messages on guidelines, when the HCP inputs an NDC, an access message shows up informing the HCP of available patient support including nursing services, hub services, and financial assistance. At that precise moment, the HCP can either print information for their patient or choose to text or email information to engage the patient in enrollment into a manufacturer patient support program.
The goal is to improve access for patients by enabling greater connectivity and coordination between the patient support services provided by pharma, patient care delivered by pharma hubs and educational nurse teams, and financial support awareness needed when filling a drug at a pharmacy. New capabilities are enabling digital automation of previously tedious manual steps such as submitting fax-based enrollment forms, tracking down a patient for missing insurance info, identifying payer requirements, and ensuring the HCP has the appropriate prior authorizations forms to submit to the payer. Automation of the prescription workflow ultimately helps get patients on therapy faster.
For example, too often HCPs are not aware of where to send a script for a limited distribution drug. The script often lands at the wrong pharmacy which then leads to the pharmacy asking the HCP for a new prescription for a different drug that the pharmacy can fill. In order to close the gap and improve the flow of scripts to the appropriate pharmacy, drug manufacturers can invest in pharmacy alert messages within the EHR to notify the HCP of the correct pharmacies to send the script to. A recent case study of a pharma manufacturer that employed EHR pharmacy alert messages resulted in 94% lift of script volume within the EHR network partners submitting to the brand’s preferred pharmacy network.
In addition, for brands with limited payer coverage, a prior authorization requirement can create frustration for HCPs, and overall low utilization of hub and other patient support services. To improve patient access and simplify the process for HCPs, a manufacturer recently deployed digital solutions to augment the customer experience. The result was an increase in HCP hub satisfaction and utilization from 5% to 20%, an increase of prior authorization submissions from 50% to 80%, and 40% of patients flowing straight to the pharmacy without the need for hub intervention. This leaves the customer service team with more time to focus on patient cases that require a higher level of care.
While pharma has made some progress in evolving digital options in the access space, there is still a lot of room for continued innovation.
Digital access technology enables an ecosystem where the patient is truly at the center of care. Patients are engaged earlier in the prescribing journey than ever before. At the point of prescribing in many EHRs, HCPs can choose to check a box that will send a text message or an email directly to the patient asking them to sign off on a pharma consent requirement, learn about financial support programs, get information on how to get started and explain what to expect on a therapy, amongst other information. Beyond that, there are other ways of continuing to engage the patient in a two-way conversation via engagement programs to ensure the patient has support in understanding key milestones along their treatment journey.
Providing patients with the maximum level of visibility, engagement and transparency from the start ultimately drives better adherence and persistence in the long-run, leading to better outcomes.
Digital innovation is at the heart of pharma strategy driving greater access and affordability. The EHR gives unparalleled access to HCPs at the point of care to deliver the most appropriate message at the most relevant time for a specific patient type. Solutions outside the EHR solve workflow inefficiencies by augmenting the customer experience of hub teams with access to technology that helps to improve speed time-to therapy for patients and alleviate prescribing confusion. The goal is to build trust with HCPs by helping them get more patients on support services and ultimately the treatments they need, in a more connected, transparent and efficient ecosystem.
Karina Castagna is SVP Specialty Solutions at OptimizeRx.
1. Medicine Use and Spending in the US A Review of 2018 and Outlook to 2023, IQIVIA Institute, 2019.
2. “Specialty Drug Spend Soars. Can Formulary Management Bring It Down to Earth?,” Managed Care, 2019.
3. Patient Services: Pharma’s Best Kept Secret, Accenture Life Sciences, 2016.
4. Automating Specialty Pharmacy: Identifying Gaps, NCPDP, 2015.
5. 2019 National Electronic Health Records Survey public use file national weighted estimates
6. National Electronic Health Records Survey: 2015 Specialty and Overall Physicians Electronic Health Record Adoption Summary Tables.