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Phil Blog
Transforming the Prior Authorization Process: How Feedback Loops can Improve Patient Access to Life Sciences Brands
The use of prior authorization (PA) to control the utilization of prescription drugs, especially specialty medications, is growing, with 79% of medical practices reporting that PA requirements increased between 2021 and 2022. By design, the PA process is a barrier to medication access – it can leave patients waiting for days, weeks, or even months for approval, and coverage denial may occur despite a therapy being appropriately prescribed. The negative consequences of delaying treatment are well documented, yet more than 8 out of 10 patients still experience delays accessing their medications for reasons such as cost and insurance challenges
Prior Authorizations: What Pharmaceutical Manufacturers Need to Know
As healthcare costs have escalated over the last several decades, public and private medical insurers have introduced different utilization management (UM) strategies to control healthcare expenditures. The proliferation of higher-cost specialty medications has accelerated the use of drug UM tools to control access, with prior authorization (PA) being the most common today. From the payer's perspective, PAs are necessary to improve quality of care and protect patients’ safety
Optimizing life sciences field teams
A persistent challenge for life sciences manufacturers is growing access and affordability obstacles, exacerbated by hard-to-enter formularies and rigorous utilization management (UM) practices. Payers are tightening the screws year over year with new cost containment strategies. Where there used to be hoops, they are now on fire, making it more difficult than ever to ensure reimbursement at the pharmacy
Phil Inc Adds Additional Duchesnay USA Women’s Healthcare Product to PhilRx
In 2018, after launching Bonjesta® (doxylamine succinate and pyridoxine hydrochloride), Duchesnay USA utilized a combination of retail and specialty pharmacies to support patient access to the medication. This channel strategy experienced challenges, particularly around patient experience and prescription coverage rates. In 2022, the Duchesnay team engaged Phil Inc looking for ways to address their patient experience and access challenges: Shipping time: Patients experienced delays to therapy after paying their out of pocket expenses
3 reasons to work with a commercialization partner
The stakes are high for life science companies when establishing the “best fit” drug distribution and channel strategy for a brand across the lifecycle, particularly since strong market access is no longer a guarantee to ensure a high percentage of covered dispenses at the pharmacy. Many manufacturers know that a critical input into maximizing gross-to-net is the pharmacy network. A robust, and varied national network of pharmacies that combine retail, chain and specialty pharmacies is the best way to maximize plan contract coverage and reimbursement rates
Ready to learn more?
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.
