Medication nonadherence is a long-standing problem linked to poor health outcomes, increased hospitalizations, and significantly higher healthcare costs. According to the CDC, out of the 3.8 billion prescriptions written in the U.S., one out of five are never filled. Even with good insurance and drug coverage, medication adherence rates for chronic conditions fall between 50-60%– a far cry from the 80% adherence rates medical experts say are necessary for optimal therapeutic efficacy.
Disease-related complications arising from drug nonadherence take a toll on all healthcare stakeholders. For pharmaceutical companies, it becomes more difficult to prove a treatment’s value, and both short-term and long-term revenue suffer which can prevent their ability to continue to serve patients.
A 2016 study estimated that the pharmaceutical industry loses $250 billion in actual and potential revenue due to nonadherence in the U.S. alone. Clearly, investing in medication adherence strategies promises the dual benefits of driving more revenue while positively impacting healthcare outcomes and costs.
Life science companies that market specialty and specialty-lite therapies are tasked with developing support programs to help patients access and stay on their medicines. A lack of awareness leads to suboptimal tractionwith many of these programs. However, enhancing awareness is not enough to achieve optimal medication adherence.
Here are three major reasons your patient services program may fail to boost adherence to your branded therapy:
Cost has long been considered one of the biggest barriers to medication adherence. The proliferation of high deductible health plans, more expensive medications, and larger copays have made it even more difficult for patients to afford the medications they need to treat their health conditions effectively.
In a recent survey published in JAMA Open Network, one out of five patients reported cost-related nonadherence. Increases in out-of-pocket medication costs are directly correlated with higher prescription abandonment rates and nonadherence. For example, a 2022 IQVIA study found that 61% of prescriptions with an out-of-pocket over $250 are not filled by patients compared to just 7% when the cost is less than $10. Another study identified an out-of-pocket threshold of $51-$75, where adherence dropped significantly.
Understanding (and addressing) the price sensitivity of the therapy’s patient population is crucial to your brand’s commercial success. You can drive better adherence through a patient services program that leverages data to offer the optimal patient out of pocket costs and ensures in-network pharmacy utilization to maximize prescription coverage. The keys to success are twofold:
Using an automated process that efficiently funnels patients to the best financial outcome for their prescribed medication.
Implementing a data-driven approach that optimizes any manufacturer-sponsored financial assistance programs by ensuring they support patients as intended while protecting your margins.
Offering patient support services is the most tangible way for life sciences companies to connect and engage with patients across their prescription journey. When it comes to driving medication adherence in 2023, a digital-first approach is essential. Simply switching to electronic prescribing has been found to increase first-fill medication adherence by 10% compared to traditional paper prescriptions.
Today’s healthcare consumers expect a frictionless healthcare experience driven by digitally enabled tools that provide:
Active participation in care and treatment
Convenience and on-demand services inclusive of refills
Options for how care is delivered and paid for
A consumer-centric digital experience should make staying on therapy as easy as possible. Tailored outreach, such as refill reminders or giving patients the option to receive their medication by mail – several studies have shown that using mail-order pharmacies improves adherence rates – will help patients get started on their prescribed therapy faster and stay on it. With the understanding that patients often face logistical barriers to medication adherence, the PhilRx platform automatically opts patients into an informed auto refill process. At checkout patients are notified of this and receive refill reminders 7 days prior to a refill via text informing them of the upcoming refill and allowing them to make any changes to their refill cadence if the timing doesn’t suit them. This process, coupled with the fact that we are able to drive higher coverage than other channels results in significantly higher refill adherence than other pharmacy channels.
Without data insights, there’s no way your team can be adequately equipped to make informed decisions that drive therapy adherence. Every touchpoint along the patient's journey can influence the likelihood of prescription abandonment, time to therapy initiation, and adherence to therapy.
Data insights offer greater visibility into the prescription process and how it impacts patients, so you can evolve your program as needed throughout the brand’s lifecycle and reduce the risk of a mid-life cycle crisis. You can develop more effective adherence strategies by tracking specific key performance indicators (KPIs) for your patient services program, such as patient engagement, time to fill, and covered dispenses.
Data analytics also provide insight into what is typically an opaque process for all stakeholders, the prior authorization process. By tracking and analyzing this data, you gain insights into the utilization of your brand, payer reasons for denials or delays, how patients and prescribers respond to delays (i.e., prescription abandonment or writing a script for a different medication), and the impact of out-of-pocket costs and reimbursements.
Pairing a data-driven approach with feedback loops helps commercialization teams develop a comprehensive understanding of the PA process, enabling them to enhance the overall process for key stakeholders – ultimately increasing medication adherence.
A patient services program in today's healthcare environment must address affordability issues, offer a modern digital experience, and leverage data insights across the prescription journey to drive medication adherence. Phil does just that – and more. Get in touch today to discover how partnering with Phil can help you transform patient access and reach brand goals.
Our consultants will work with you to analyze your current channel strategy and make recommendations for how to improve patient access and increase the percentage of scripts getting covered by insurance.