On October 10th and 11th, leaders from throughout the healthcare industry gathered to discuss how we can best address the needs of today’s patient by becoming more health focused in our commercial and clinical endeavors. I was fortunate enough to be one of the presenters at this important event, and was able to share how Ashfield is working within the industry to deliver effective programs in the evolving patient and physician support models.
It is true that the industry has evolved from a model where the ‘doctor knows best’ to one that is more patient centric. Certainly, patient support programs (PSPs) have evolved to become a ‘cost of entry’ for specialty drugs in particular. There are numerous reasons leading to this recognition of the need to better serve patients. The estimated $546 billion of lost revenue reported in 2015 by CapGemini due to medication non-adherence is a key factor along with the 50% of patients reported not to be taking their medicine as prescribed. Sadly, it is reported that 83% of patients would never tell their doctor they did not plan to fill the prescription just written for them, and yet 74% of physicians believe their patients are taking the medication as described – a true disconnect.
According to The National Association of Chain Drug Stores, the numbers on non-adherence can be truly staggering and yet, if overcome and coupled with proper disease management, could result in a total potential savings of $290 billion annually in healthcare costs.
Add to these sobering statistics, the movement within healthcare towards outcomes-based reimbursement, and the rising empowerment of patients, and we can quickly see that there is a lot at stake for pharmaceutical companies and health care providers alike to better serve its patients.
So what can we do?
We can develop PSPs that increase value to the patient by taking into consideration all the players within today’s healthcare delivery model: the patient and caregiver, physician, specialty pharmacy, reimbursement support, MSL and/or sales rep, the payer and nurse educator within a financial and global construct. Our goal in each PSP should be to contain costs by improving adherence, reducing readmissions and achieving better outcomes.
And we can do so most effectively by moving beyond ‘me too’ programs. We need to create outreach that is truly targeted to the patients as individuals, their caregivers and the HCPs treating them throughout the journey.
And how do we do this?
We start by understanding the reason for non-adherence to a medication regimen. Once a patient is diagnosed with a condition and prescribed a medication to manage that disease state, it is imperative that patients take the medication as prescribed. Yet time and again, as noted earlier, patients elect not to take their medication. There are many reasons attributing to this, but our research has shown there are five key dimensions of non-adherence to take into consideration when developing a PSP:
- The actual disease state/condition and the overall health of the patient
- Socio-economic factors
- Knowledge of the patient condition within the actual health system
- The patient’s mental attitude, emotional health and daily routines
- The actual therapeutic regimen
Knowing these factors all play a role in patients’ receptivity and adherence to medication, doing some upfront research within the patient demographic can provide program guidelines for effective patient and physician support programs.
At Ashfield, we use adherence risk assessment tools at the beginning of our engagement to help our clients outline the most effective patient and caregiver support programs. This consists of field and desk research of patients leading to identification of key target segments. Once the demographics of the key targets are defined, unique communication messages and methodologies for each segment can be developed and tested to not only resonate with patients, but give them the support needed to stay on track. We recognize that everyone learns in a different way. Rather than the ‘one size fits all’ PSP, the support plan may end up looking something like this in order to address the ‘whole’ patient.
These contacts will cover the patient throughout the journey, providing disease state education and support via the phone, health apps, computer interactive experiences and in-home training when appropriate. This outreach starts at diagnosis and continues through treatment.
Let’s not forget the physician
Even though our emphasis as an industry is shifting to meeting the needs of today’s empowered patient, it is critical that the physician hears what patients and their caregivers are saying about their treatment and how they are dealing with the disease. It is only by understanding these factors, that the physician can truly serve the patient and effect outcomes.
Therefore, it is critical that we address the need for this feedback loop as we develop our supporting data technologies, as a communication gap between physician and patient doesn’t benefit anyone.
Remember – it’s a journey, not a sprint and at Ashfield we are prepared to partner on a global level to deliver an end-to-end experience for patients and HCPs.