Five ways to adapt manufacturer-sponsored programs
As social distancing and stay-at-home orders became commonplace in response to the Covid-19 pandemic, many patients chose to put off non-urgent doctor's visits, eliminating a common point of contact with their healthcare providers. At the same time, millions of Americans have lost their jobs, and, as a result, their insurance coverage.
For decades, patient support programs have assisted patients with navigating challenges of medication access, affordability and adherence. Now, amid a pandemic that has led to extraordinary economic upheaval across the world, patients and their families face new financial and physical interaction challenges, which may affect their ability to access and afford critical medical care.
Manufacturers and their partners must be agile and modify their support programs to meet patients’ evolving needs. There are several adjustments manufacturers should consider to ensure patients experience uninterrupted access to medication—both now and in the months that follow.
Expanding patient assistance
At the onset of the pandemic, many experts predicted the demand for patient support and financial assistance would surge. Although demand didn’t instantly skyrocket, the persistence of the virus and continued economic trends have led to a steady increase in the need for patient support and financial assistance.
Patients who would typically not qualify for patient assistance programs (PAPs) may now be facing new financial pressures. To meet this growing need, manufacturers should consider expanding eligibility for programs—whether it’s expanding the criteria to cover the newly unemployed or extending the re-enrollment period for those unable to renew their applications promptly. It’s critical to provide these patients with support, so they do not ration their medication or forego it entirely.
Manufacturers may also want to expand the types of services offered via their PAPs. For example, manufacturers can work with their partners to help patients get 90-day refills—instead of monthly refills—to reduce refill frequency and to better ensure continuity of care.
Evolving communication strategies to increase awareness of patient support programs
Under normal circumstances, many patients learn about and enroll in patient support programs at the doctor’s office. But there have been far fewer in-person visits amid the pandemic, as most appointments shifted from in-person to virtual visits. Data from physician practices shows that specialty practices have seen a decrease in new patient visits ranging from 40-85%.
Awareness of patient support programs among healthcare providers and patients was low prior to the pandemic—only 40% of healthcare providers were “very aware” of manufacturer-sponsored patient services, according to a report. With that in mind, manufacturers and their partners need to develop a sound field services strategy and a plan to engage providers and patients in this virtual environment.
Manufacturers should consider establishing a website, or virtual portal, that provides patients with information about patient support programs and allows them to enroll online. For example, Lash Group developed a new portal that patients can access to submit documentation and complete enrollment. We’ve found patients have been pretty quick to adapt to using technology to engage with us—whether it’s uploading forms via mobile devices or connecting with nurse educators on a video services platform for injection training.
Exploring alternative coverage
Many people who were accustomed to getting their health insurance through their employer may now have to navigate enrolling in COBRA, Medicaid or a marketplace plan—potentially for the first time. The temporary loss of—or change in—health insurance can disrupt one’s access to critical medications.
To reduce the possibility of any gaps in coverage, patient support programs can work with patients directly to explore alternative coverage options and help them enroll in a health plan.
Providing personalized virtual assistance
Patients who aren't seeing their doctors in person may have lingering questions about their medication that could affect adherence, especially for patients with chronic or rare diseases. Patient support programs can help drive sustained adherence via digital tools and virtual services. For example, at Lash Group, we’re offering services like virtual injection and administration training, which can help to instill confidence in patients and help them manage complex medicines regimens—without having to leave their own homes.
Patient education services play a vital role in driving patient adherence—particularly now in this virtual environment. Our research suggests that education services can improve adherence to prescribed therapies by as much as 15%. Nurses can connect with patients via a secure digital platform to address any concerns and educate patients on relevant clinical information, helping to empower patients in their treatment journey.
Streamlining benefits verification
Simplifying access to therapy is critical to ensure patients receive the therapies they need as quickly as possible. Even under normal circumstances, the process of verifying a patient’s benefits can disrupt care. Changes in health insurance coverage and a shift toward a more virtual environment can create additional barriers, making it a more complex process.
In order to expedite the process, manufacturers should determine if electronic benefit verification (eBV) solutions are right for their programs and for the patients they support. As coverage changes, benefit verification solutions, powered by artificial intelligence and machine learning, can help to determine eligibility quickly, thus accelerating one’s speed to therapy. The implementation of technologies, such as “digital assistants,” can make automated calls to payers if an eBV is not possible.
While the Covid-19 pandemic has created new barriers that can impede patient access to critical therapies, pharmaceutical manufacturers and their partners can work together to help patients receive the medication they need. Manufacturers can make a few strategic adjustments to reduce gaps in care, including expanding patient assistance, evolving interactions with patients and providers, exploring alternative coverage, providing virtual assistance and streamlining benefits verification. These changes will help ensure manufacturers’ therapies remain affordable and accessible to every patient who needs them.
About the author
Tommy Bramley, PhD, is president of the Lash Group.