When meds really matter

The health care landscape remains as tricky as ever for patients trying to navigate their medication journey. While the advent of specialty drugs has been a game changer for patients, the reality of getting these life-changing medications into the patient’s hands remains much harder than it should be.

And that’s because the kind of rapid and extensive innovation we have seen in life sciences and pharmaceuticals have not been mirrored in the prescription processes that control how patients get medication in their hands.

The administrative burdens of the prescribing and approval processes involved create unnecessary and frustrating hurdles for both providers and their patients who require specialty medications. And the costs are great for both sides of the equation, too. As a result, creating a seamless, streamlined infrastructure is imperative for improving patient outcomes and for actually getting these innovative treatments into patient’s bodies. But how do we do that?

Here are steps we can take to innovate the prescription process and improve the specialty patient’s medication journey:

Getting Patients on Their Therapies, Faster

The experience patients have en route to therapies prescribed for them by their provider is often fraught; they may have been sick for months or even years, with diagnoses slow to materialize after having seen a host of providers along the way. Once a therapy is identified that the prescriber believes will help them, patients should be breathing a sigh of relief because there’s finally a clear course of action. And yet there are often invisible booby traps that keep them from getting on this treatment.

In fact, the process of going from script to adoption to adherence is itself incredibly difficult, with patients often unaware of how and where to proceed. In prior years when a buy-and-bill model was in place, patients were guided by their providers, who were motivated to make this as easy as possible. Under today’s model, patients are essentially on their own post-prescription.

Add to this the difficulties costs create.We know that the average patient follows the national demographic trends of having high deductible insurance plans, which have gone from approximately 3% of all plans in 2006 to an estimated 40% as of this writing.

Luckily, innovations that are invisible to the patient have emerged that can help make this entire journey both less onerous and more affordable for the patient.

Synching Parallel Patient and Provider Paths

This is done by removing the aforementioned booby traps present throughout the process. And the best place to start is identifying where these exist in the patient and provider processes.

We know physicians are frustrated with the administrative burdens that keep them from being able to focus more attention on their patients. In fact, a 2019 survey published in this very periodical showed that the issue that is most “ruining medicine for physicians” is actually paperwork and administrative burdens. And the medical office staffs that are on the front lines of these mountains of processes and paperwork are arguably even more burdened.

This is where the likes of pharmaceutical patient support services (also referred to as “hubs”) can be of use. In a survey conducted in 2020, we found that 7.4 out of 10 hub users report high overall satisfaction with them, and a majority feel it plays an important role in helping patients get on therapy. At the same time, ease of use and convenience mean that office workflow is significantly improved.

Our survey found that key services perceived as most helping patients are managing benefit verifications and PA hurdles and determining the best affordability options for the patient, such as patient assistance programs (PAPs) and copay program enrollment. Providers can check the manufacturer’s brand website to learn if there are hub services that can help. Once the patient is connected with a program like this, they have direct access to support and information outside the provider’s office. It’s a big win to connect the patient with expert help that doesn’t drain provider resources.

For patients, hubs support all different varieties of financial realities. For those for whom copays will work, they are easily identified. For those without insurance or who are on Medicare – scenarios in which copays will not apply – hub processes help providers determine how benefits can be employed in order to make the path to necessary therapies easier.

Meeting Patients Where They Are

On top of the roadblocks we’ve previously outlined here is the known trend in lack of adherence to medication, which impacts as many as 40-50% of chronic-disease patients. In order to support better patient outcomes, you have to meet patients where they are. When starting a new therapy, patients not only must deal with the complexities that arise between the time a therapy is prescribed and when they actually begin treatment, but they also face the daunting task of integrating medication schedules, managing side effects and/or chronic pain, and a host of other realities that come along with the therapy.

Streamlining access to support services via channels such as mobile is vital for patients, as it allows them to interact in real time as they embark on their journey. At the same time, providers benefit by gleaning valuable insights into patient behavior. Understanding which services patients are using via which channels and how often lets providers optimize efforts to reach them where they are, ultimately supporting better patient outcomes.

For patients navigating their specialty medication journey, the experience is often a scary and painful one. Removing barriers to adherence by incorporating tools that make the process invisible, seamless and affordable can make all the difference between successful treatment and abandonment.

Julia Laurin is Chief Product Officer at ConnectiveRx.