Industry Insights

AssistRx’s 2020 Outlook: Specialty Pharmaceutical Market – Pt. 1


Part 1: Hub Model Considerations

As we begin 2020, a key theme in the industry is implementing the right balance of technology and talent to best serve patients and healthcare providers. With the growing number of targeted therapies serving unique patient and provider populations, industry leaders agree technology or talent alone cannot fully address the needs of all stakeholders.
In this three-part series, we will examine:

  • Today’s growing number of targeted, complex therapies and their evolving patient and provider needs
  • The resulting need for life sciences organizations to meet providers and patients where they are and engage them with real-time, targeted information through a technology- and talent-enabled approach
  • Two examples of how to achieve this through a balanced approach–real-time benefit check (RTBC) and e-prior authorization (e-PA)

Smaller, Targeted Therapies

The industry is seeing a growing number of new products serving patients in smaller, more targeted therapy groups, then adding indications throughout the product lifecycle. When choosing a patient solutions provider, it is important to consider whether the provider can grow alongside the brand and scale throughout the lifecycle of the product. The patient solutions providers’ customer relationship management (CRM) tool is also an important consideration. If the CRM is unable to integrate with or house several business tools, it may be necessary to add on several different platforms as the product grows, which can become expensive. Therefore, choosing a patient solutions provider with a flexible and robust CRM will be more cost effective as more indications are added and/or patient volume grows over time.
In addition to technology that facilitates economies of scale, these therapy programs require educational outreach at launch to providers, specialty pharmacies, payers and patients/caregivers about the therapy, available support programs and how to navigate access challenges. Educational efforts vary depending on the product. A first-to-market launch requires significant education efforts and outreach to key opinion leaders about clinical trial results, mechanism of action (MOA), reimbursement process, support programs and more. A launch into a crowded space requires a familiar workflow and services that are considered standard to that provider and patient population. Since most of these therapies will face PA and appeal challenges, life sciences organizations should consider PA support, letters of medical necessity templates, quick start programs and other efforts to improve access and speed to therapy.

Evolving Provider and Patient Populations

For certain therapies with highly motivated patient or caregiver populations and technology-savvy provider populations, self-serve online portals are ideal to streamline processes and meet patients and providers where they are. For example, AssistRx built a workflow in its integrated therapy initiation and patient support platform, iAssist, and a patient-facing branded engagement site to facilitate greater access to a client’s portfolio of HIV medications. The iAssist workflow proactively collected all information electronically, reducing errors and missing information, expediting access to therapy. The patient- and provider-facing branded engagement sites provided 24/7 access to this highly motivated, underserved patient population for:

  • e-Consent
  • Copay assistance screening and real-time approval
  • Patient assistance program (PAP) screening and real-time approval
  • Helpful disease state and therapy information

As a result, access and speed to therapy for this patient population improved, and AssistRx saw a 257% increase in utilization of the client’s PAP, thereby aligning with the client’s business objective.
For therapies with less sophisticated provider offices and/or patients who lack access to digital tools, a higher touchpoint model is ideal. Patient solutions teams should proactively reach out to providers to educate them on the enrollment and reimbursement process. These teams can also facilitate enrollment into copay assistance, PAP, bridge and quick start programs over the phone to reduce the back-and-forth while ensuring an optimal patient experience.
In today’s environment of evolving therapies and patient and provider populations, a tailored approach is essential for program development. Life sciences organizations must also ensure they are choosing a partner who can grow with them throughout the lifecycle of their product and adapt to the ever-changing healthcare space. In our next blog, we will discuss how to engage patients and providers with real-time, targeted information.
To learn how AssistRx combines technology and talent to improve program performance and create better results for today’s patients, contact us.