The Healthcare system is notoriously complicated and opaque, making it arduous for patients to navigate successfully. That’s why there’s been a legislative push to increase transparency across through policies such as the No Surprises Act and Hospital Pricing Transparency rule.
Getting access to prescribed therapies to treat complex medical conditions can be especially difficult and stressful for patients. Drug utilization management programs, such as prior authorization (PA) and step therapy, often lack the transparency required for patients and their providers to make informed treatment decisions that enable patients to adhere to care plans. Recently, CMS proposed several new policy measures as part of the Interoperability and Patient Access final rule in an effort to make the PA process more efficient and transparent.
Facilitating access to their branded specialty-lite therapies is a primary objective for life science commercialization teams. Here are four reasons why manufacturers should make transparency a core element of a brand’s patient services program.
The pharmaceutical industry has a trust problem. A 2021 Accenture survey revealed that only 16% of consumers believe that pharmaceutical companies market their products in a trustworthy manner. Yet, nearly a third of respondents believe that providers work closely with pharmaceutical companies to inform health recommendations in their best interest.
Research shows that trust in healthcare impacts treatment adherence, patient satisfaction, and health outcomes – all of which are crucial to a branded therapy’s success. One of the best ways to build trust is through transparency. Pharmaceutical manufacturers have a significant opportunity to build trusted relationships with patients and healthcare providers by enabling greater visibility during the prescription journey with tools that improve patient access.
The modern patient expects to be an active consumer of healthcare services, but often lacks transparency to make informed decisions. Multiple potential gaps exist in a patient’s prescription journey from diagnosis to treatment initiation to follow-up, with each touchpoint an opportunity for pharmaceutical manufacturers to enhance transparency.
Patient access and support services are the most tangible ways for life sciences companies to connect and engage with patients. HUB services can meet patients where they are if they are driven by digital tools that deliver a frictionless, consumer-centric experience on par with what consumers experience in other industries. Tech-enabled patient services not only allow life science companies to do more with less but also support an enhanced transparency that:
Makes it easier for patients to access and afford their treatment
Gives patients options for how to engage and receive communications
Allows patients to have full visibility into the status of their prescriptions
Check out this eBook to learn how to deliver a consumer-centric experience to achieve your brand’s commercialization objectives.
Ensuring patients have timely access to prescribed therapy is critical to better outcomes and, ultimately, a brand’s success in the pharmaceutical marketplace. Today’s reality for pricier retail and specialty-lite brands is that the PA process presents obstacles that inhibit access.
In a 2022 survey by the American Medical Association, 80% of physicians reported that a PA can sometimes lead to treatment abandonment. When patients cannot begin treatment promptly, their health outcomes suffer. In the AMA survey, 94% of physicians reported care delays associated with PAs, and 89% believed the PA process had a negative impact on patient clinical outcomes. Furthermore, physician offices reported spending almost two business days on average completing PAs.
Life science companies can drive speed to therapy by incorporating partnerships that deliver seamless electronic PA processes. Manufacturers should prioritize solutions with integrated transparency tools to help providers make the best decisions at the point of care, simplify the information gathering process, and keep everyone informed to avoid the typical delays that prevent patients from accessing their medications.
Download this Prior Authorization Guide for Life Sciences Companies to discover how your team can reframe its approach to PA through digital solutions that boost patient access.
It’s not unusual for patient services programs to fall short on medication adherence objectives, and a lack of transparency can be a culprit. Considering that one out of five prescriptions are never filled, and medication adherence rates for chronic conditions are only 50-60% - even with good insurance and drug coverage – pharmaceutical manufacturers should make every effort to help patients adhere to their prescribed therapies.
By leveraging digital technology and data, brand teams can improve adherence by increasing transparency around the prescription journey for patients in the following ways:
Sending out personalized digital refill reminders
Providing education on proper administration, dosing, storage, and side effects
Facilitating communications through a user-friendly mobile application
Alerting nurse navigators to reach out to patients at risk of non-adherence
Offering real-time visibility into benefits verification, PA, program enrollment, and copay status
Life sciences companies face substantial hurdles to enabling access to their specialty-lite brands, and they cannot afford to miss a piece of the puzzle regarding their patient services programs. A technology-enabled HUB that delivers the visibility patients and providers expect will help them effectively and efficiently manage the complexities of patient access.
Phil partners with pharmaceutical manufacturers to bring clarity to the prescription journey. Our patient support platform improves outcomes and experience by enabling speed to therapy with the lowest possible out-of-pocket burden. Learn more here.
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.