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The last two years accelerated the uptake in technology faster than previously expected, opening remote and virtual gateways for the healthcare industry as healthcare providers and consumers quickly adopted and grew comfortable using digital tools and communications. At the same time, the pipeline for innovative and novel therapies in oncology and rare disease for cell and gene and specialty products has continued pacing toward regulatory approval.
When treatments become available and patients are identified as eligible to receive them, these individuals will require services to support them through the entire treatment journey. In addition to their patient support model, manufacturers will need to consider approaches to support integrated registry models, addressing post-approval requirements and data strategies that support value-based contracts and regulatory reporting requirements that face these types of products.
With these advances in technology, despite the gravity of the difficulties brought on by the pandemic, the biopharmaceutical manufacturers of these drugs can now more easily reach patients and provide patient support programs. That is, so long as these manufacturers take advantage of advanced technologies to offer holistic programs that support the patient journey, and account for access, affordability, and adherence.
To help connect patients to the services they need, this article shares strategies and best practices for developing and implementing high-tech, high-touch patient support programs for innovative and novel therapies.
By the time a patient gets diagnosed and has a treatment identified, they likely have already endured a long mental, emotional, and logistical medical journey. Understanding the inherent complexity of such patient journeys from start to end of therapy is critical for supporting patients access to therapy and ongoing adherence. With this in mind, patient support services need to address core access components and build a support structure (and potentially a community) for patients who may feel isolated based on their diagnosis.
Patient service programs are grounded in access, affordability, and adherence support designed to meet the unique needs of each patient and specialized therapy. Because of the increasing complexity of therapies, manufacturers must be prepared to work and develop collaborative support strategies across multiple stakeholders — including prescribers, laboratories, apheresis centers, distribution partners, and treatment facility/facilities, for example.
One of the first decisions manufacturers need to make is whether to manage the full spectrum of end-to-end services in-house, through third parties, or via a hybrid approach. Interestingly, the industry as a whole has shifted course on the preferred method a few times. After relying on in-house teams for patient services, many companies switched to fully outsourcing this function. More recently, after some trial and error, manufacturers are increasingly starting to manage some scope of the operations in-house, while enlisting specialized partners for certain services and program aspects. Especially for complex therapies with intricate patient journeys, this approach seems to give the manufacturer more control over the customer experience. It also gives them crucial insights into the effectiveness of the patient service program itself, as well as for overall business decision-making and portfolio planning.
Regardless of the program design, biopharmaceutical companies must be prepared to meet patients where they are to support positive patient outcomes. The good news is that it is easier than ever before for manufacturers to streamline engagement across registries, clinical studies, and patient support services, thanks to several factors:
For example, electronic health records (EHR) and real-world data can be leveraged for direct-to-patient recruitment for clinical trials and post-market approval treatment programs. Life sciences companies can use this capability to efficiently identify and recruit ideal patient candidates, leveraging specific International Classification of Diseases (ICD-10-CM/PCS) codes and through partnerships, such as with healthcare networks.
For patient support programs, electronic healthcare technology solutions can be used to bridge providers, patients, payers, and service providers by digitizing and streamlining the administrative and authorization parts of the process. This can be done by electronically completing enrollment forms, capturing patient or provider signatures, electronic benefit verifications and prior authorization, income verifications, etc.
Once a patient is selected, digital assistants can be used to facilitate the treatment journey, beginning with the enrollment and consent process through to appointment or fill reminders.Digital assistance can support previews of what to expect with upcoming visits or shipments, address patient questions and provide patients with warm leads or entries into next steps and milestones. Supporting a high-touch service approach, digital assistants can drive improved contact rates resulting in two fewer call attempts per patient and can be used to capture individual patient reported outcomes. Patient service programs that utilize digital assistants have an average 12% lower rate of patients choosing to leave therapy, an 18% increase in number of shipments per patient and have higher positive patient sentiment rates (95%).1
Furthermore, biopharmaceutical companies can leverage advanced analytics to solve tactical issues, like aggregating disparate data sets and improving processes, as well as to assess patient outcomes and drive business insights. Assuming appropriate authorizations are in place, they can also share relevant and necessary information with foundations and external registries to advance the understanding of the treatment option, disease, and epidemiology, including for medical, scientific, and advocacy efforts.
All that said, biopharmaceutical companies need to balance the use of digital solutions with the reality of the human condition. Despite how comfortable patients and providers have become with communications and authorization technologies, best practices continue to dictate and corroborate that “high-tech” is best served with “high-touch” patient support programs. To this point, “case manager first” engagement models are still preferred among patients and providers, and generally show higher engagement and adherence rates.
In these programs, specially trained case managers foster and nurture the patient experience by serving as a consistent, reliable, and empathetic point of contact for patients from initial access and engagement through the end of therapy. Their role varies depending on the specific indication and support program, but often entails conducting personalized outreach to educate on the product or disease state, as well as to prompt patients throughout the treatment journey, including providing support for matters of access, affordability, and adherence.
As a result of these innovative high-tech, high-touch solutions and methodologies, biopharmaceutical companies can more easily and expertly tailor patient support programs to meet the needs of the indication, and, just as importantly, of the individual patients and providers. Already, manufacturers deploying these methods are seeing increased rates in enrollment and adherence.
For example, in one recent case, a biopharmaceutical company faced the challenge to provide comprehensive care coordination for a lifesaving, high-cost, single-dose gene therapy for a pediatric rare disease. They aimed to connect families, prescribers, sites of care centers, genetic testing labs, a third-party logistics partner, co-pay/alternate funding partners, product manufacturing, and distribution together with robust reimbursement and access services. They enlisted a third party to design and implement an end-to-end patient support program plan that tied all the partners together. After evaluating each of the stakeholders’ areas of responsibilities and necessary functions against the patient treatment journey, they initiated an integrated plan in which each stakeholder had clear expectations regarding their own and one another’s roles and responsibilities. This included real-time notifications for logistical movement of the product against set timelines, providing and receiving relevant updates to all stakeholders.
As part of this “patient first” plan, a dedicated case manager reached out to individual caregivers to welcome them, explain benefit details, set expectations, answer questions, and support their navigation through the complex treatment process. The dedicated case manager was available to support the patient and their caregivers through the entire treatment journey and support post-treatment assessments.
With a comprehensive support model in place, the product launched. In real terms, the first patient received this life-saving treatment only nine days after the initial referral was received at the program, exceeding the company’s expectations for product access. Thus far, over 700 rare disease patients have received the life-saving treatment within the first three years of launch.
That’s just one example of how creating a high-tech, high-touch patient support plan can help connect patients to the life-changing care and support they need. Especially considering the complexities of innovative and novel therapies in disease states where patients often are difficult to find, reach, and engage, implementing best practices for end-to-end support services can be the critical difference in giving patients and their caregivers the education, access, and mechanisms to improve their individual outcomes. These capabilities also increasingly will be the crucial difference in giving biopharmaceutical companies the information and insights they need to continue advancing and innovating.
Dana Edwards is Vice President, Patient Access & Strategic Engagement for UBC.
1. Based on UBC program data from May 2020-December 2021, including 18,000 conversations across six programs.