Maria Kirsch is President of Patient Services at EVERSANA. 

Maria Kirsch, EVERSANA

Patients today too often find themselves navigating a myriad of challenges that can make accessing quality healthcare a daunting task. Various common obstacles range from financial barriers to long wait times, to geographical and technological limitations and much more.

As someone deeply invested in improving patient health outcomes, I’ve had numerous conversations with patients, healthcare providers (HCPs), and pharmaceutical manufacturers who echo the sentiment that these barriers can significantly impede patient access, affordability, and adherence.

In light of all of these complexities, it’s crucial to understand the specific hurdles patient services programs must overcome. Here are some of the top ones.

Over 60% of patients report wanting more information when deciding where to get care. They often feel lost navigating their treatment options and need clearer guidance on therapies available to them. This gap in reliable healthcare information can lead to poor decision-making, and, often, non-adherence to prescribed drugs, which only worsens health outcomes.

The average wait time for a new patient appointment in the US is a staggering 26 days. Imagine being in pain or facing a health issue, and having to wait nearly a month to see a provider. This is not just inconvenient; it can lead to delayed treatments and increase reliance on already overburdened emergency services.

Between 2019 and 2022, hospital drug expenses per patient increased by a reported 19.7%. This rise in the cost of therapies can place an incredible financial burden on patients, particularly those with chronic conditions or requiring specialty medications. As a result, many patients are forced to make tough decisions about whether they can afford to continue treatment.

Factors such as income, education, and location have a significant impact on healthcare access. Patients living in rural areas or low-income households often face additional barriers to receiving care, contributing to growing health disparities.

When care is not well-coordinated, patients often find themselves bouncing between HCPs without clear communication or cohesive treatment plans. This fragmented care leads to miscommunication, duplicated tests, and inconsistent treatments.

In an increasingly digital world, access to and basic knowledge of technology is becoming more essential to access care, yet only 58.5% of adults reportedly used the internet to look for health or medical information in 2022. This digital divide means many patients are missing out on the benefits of telehealth, online appointment booking, and digital health management tools, limiting their engagement and access to services.

Turning obstacles into opportunities for success

It’s clear these significant obstacles can prevent patients from receiving timely, affordable care and contribute to a healthcare environment where many patients struggle to navigate their treatment journeys. These barriers not only hinder patient outcomes but also increase the burden on HCPs and patient services programs.

Addressing these issues requires a multifaceted approach. We must focus on advancements such as enhancing patient education and access to reliable information, along with the utilization of digital platforms that empower patients to make informed decisions. Reducing wait times can be achieved through process improvements and leveraging telehealth to expand access to care. By prioritizing these strategies and others, we can begin to create a healthcare system that better serves patients in need.

In recent years, there has been a notable shift in how manufacturers launch new therapies, acquire patients, and provide ongoing support. The concept of "patients as consumers" is finally becoming a reality as manufacturers seek to meet the evolving expectations of today’s healthcare marketplace. With patients expecting more convenience, information, and engagement, direct-to-patient (DTP) models have emerged as a game-changing approach to meet these demands.

DTP models offer a transformative approach to addressing these challenges, providing numerous benefits for both patients and manufacturers. These models bypass traditional healthcare intermediaries, providing patients with direct access to therapies and services. Not only do DTP models streamline processes, they also enhance the overall patient experience.

By leveraging DTP models, we can address many of the systemic issues that hinder patient care. DTP models help simplify the healthcare journey by ensuring patients receive timely and accurate information, personalized support, and more affordable treatment options. The following are some of the key benefits that DTP models bring to the table:

By utilizing DTP models, patients are empowered with accurate, timely information about their therapies.

I’ve spoken with physicians who have witnessed this firsthand: When patients are given clear, direct communication about their treatments or interventions, they feel more in control of their healthcare decisions and are more likely to adhere to their prescribed regimens.

 By streamlining processes, DTP models can reduce the time it takes for patients to receive their medications or therapies, ensuring quicker access to care when it matters most.

DTP models allow for more personalized care. Patients appreciate having direct access to tailored support services, such as educational resources and adherence programs, which can improve their overall health outcomes and satisfaction with their care.

DTP models foster direct communication with patients, encouraging them to stay engaged with their healthcare. Because patients are more informed and supported, they’re more likely to adhere to their prescribed treatments.

 In many parts of the country, physician shortages and geographic isolation prevent patients from accessing the care they need. DTP models help eliminate these “medical deserts” by making therapies accessible, regardless of location. This is especially critical for patients with rare or complex conditions who may not have easy access to specialists.

DTP models leverage data and analytics to provide a more personalized and seamless healthcare experience. By collecting real-time patient data, manufacturers can tailor support services, adjust treatment plans, and deliver proactive care that meets individual patient needs.

Charting a path toward a healthier tomorrow

While the challenges facing patients and patient services programs today are numerous and complex, there are successful pathways to improving health outcomes and creating a more equitable healthcare system. Through collaborative efforts and implementing innovative solutions such as direct-to-patient models, we can tackle obstacles and help ensure patients receive the quality care they deserve. As we continue to address these challenges head-on, I am optimistic we can pave the way for a healthier future.

Maria Kirsch is President of Patient Services at EVERSANA.

Articles

A guide to overcoming the top obstacles facing patient services programs today. 

From Challenges to Solutions:  Breaking Barriers to Revolutionize Patient Services 

Healthcare journeys vary widely from patient to patient, impacted by unique factors such as age, gender, severity of symptoms, access to specialists, insurance coverage, and more. Amid these complexities, adherence to prescribed therapies emerges as a linchpin for achieving positive health outcomes. However, the healthcare industry continually grapples with persistently low adherence rates, posing a significant challenge to patients’ well-being.

Addressing low adherence rates demands a holistic approach that integrates patient-centric strategies and innovative technologies across the entire patient journey. In order to be successful, manufacturers must embrace proactive measures to eliminate barriers and empower patients to navigate their own healthcare journeys.

By providing accessible, personalized, and technology-driven solutions such as telehealth services, electronic benefit verification (eBV) tools, and mobile applications that deliver real-time reminders, manufacturers have the opportunity to foster greater adherence and promote patient autonomy.

Furthermore, advancements such as predictive analytics and machine learning offer invaluable insights into patient behavior, enabling tailored interventions to support adherence. By analyzing historical data and identifying patterns, manufacturers can anticipate patients’ needs and deliver targeted support, ensuring timely access to care.

Expanding access to healthcare services through telehealth and channel management strategies also can increase adherence rates by enabling patients to access care remotely, securing seamless medication distribution and minimizing supply chain disruptions.

Transparency in pricing and cost verification is also paramount when addressing affordability barriers. Price transparency and a timely, streamlined benefits verification processes can allow patients to make informed decisions about their healthcare, alleviate some of the burden of financial stress, and result in accelerated access to medications.

Finding the right solutions to drive better access for patients, improve affordability, and drive adherence is challenging. In a sea of vendors, here’s what should manufacturers look for:

 There are a lot of great companies with amazing platforms, but a common challenge we see with vendors is, while their tech is strong, their intricate knowledge of the life sciences or pharmaceutical industry, specifically around commercialization, may be limited. Find partners who have the technological backbone but also have helped—through their technologies—bring therapies to market to help patients.

2. Knowledgeable in direct-to-care models:

 A growing facet of the life sciences industry are models that offer connectivity directly to patients. Can your partner combine advertising, telehealth, pharmacy billing, benefit verification, reimbursement, and dispensing in one model that can empower patients to obtain faster access to providers and their prescribed therapies, while also benefiting from the latest affordability automation that provides price transparency? If so, it’s a model worth looking at that can reap tremendous rewards.

 A buzzword for years in the industry has been omnichannel—delivering connections across multiple channels (email, social media, website) to multiple audiences (patients, physicians) in an orchestrated manner. Most companies have built platforms to connect with clinicians, but will that be enough to produce a successful connection? Make sure you consider all options.

4. Embracing AI and innovation at every step:

 Technology is important, as it’s the backbone of what we do. But you also need a partner that embraces new ways of thinking and innovative solutions that are quickly evolving. Artificial intelligence, machine learning, and similar technologies are changing how we can stay connected and interact with patients. They are driving more efficiencies than ever before. Yet they also must be utilized carefully in the highly regulated pharmaceutical industry.

Manufacturers that embrace the future of technological innovation, lean on trusted partners with a proven record of delivering, and remain relentlessly focused on the needs of patients are the ones that will rise to the top. And that’s how we as an industry can continue to make an impact.

Why manufacturers should leverage technology to address low adherence rates.


The Power of Patient Adherence Tools to Improve the Patient Journey

Every journey is different. True in life. And most certainly true in a patient’s healthcare journey, especially for complex conditions. Depending on a variety of factors—patient age, health status, underlying conditions, diagnosis—every step toward treatment is unique. Patients who have received, for example, a cancer diagnosis or are managing one or more chronic conditions or a rare disease—along with their family members and other caregivers—require many forms of effective and empathetic support to help them navigate the ups and downs associated with managing today’s complex and often costly specialty therapy regimens.

Thankfully, for many patients and their families, drug manufacturers know it is challenging. And many are working to create better roadmaps for patients that put their needs and concerns top of mind. As this work evolves, it is critical that as patient support programs are built, they are well-thought-out and incorporate both human and digital touchpoints while being grounded in data to truly improve outcomes. To do this right, we must understand today’s patients, how they consume information, manage the complexities of their conditions, and then do everything possible to simplify how they can complete daily tasks needed to stay on therapy for as long as possible.

And it starts with establishing the right objectives for programs and embracing innovation.

Establishing the right objectives, embracing innovation



The right objectives are key to a product’s launch success. And since patients come first, the three we always come back to are access, affordability, and adherence. If we keep these three areas as our guiding north star, everything else will follow.

. When a clinician has selected a therapy for a patient, there are several factors that can create delays or even prevent physicians from helping patients get on the therapy. Formulary tier status, prior authorization or step-therapy requirements, labor-intensive coverage appeal process, and many more. These can delay access for days, even weeks and months, leaving patients helpless. Similarly, the network for specialty pharmacy centers managing, for example, oncology treatments, has narrowed drastically in recent years, creating additional hurdles. Thankfully, innovation is occurring in some places with wraparound-type programs that streamline the prescribing process by tapping digital tools into physicians’ workflows that help provide access to experts who can help break down these barriers.

 Therapies are expensive. And in many instances, costs are rising. For patients with high deductible plans, out-of-pocket expenses can be steep. To help in the battle of affordability, support programs must improve the process to help patients find alternative options to make mediations more affordable. This too can be powered by digital tools and trained specialists that can quickly look for comparable products or find Patient Assistant Programs offered by manufacturers to help reduce financial burdens. Incorporating these elements into programs again puts the needs of patients first.

 Once patients have access to affordable therapies, how can we help them stay on them? Effective programs do this through caring, experienced staff that can help answer their questions at the touch of a chat or call on the phone, but also through data-driven digital reminders that meet patients where they are. Whether they prefer email, text, or a phone call reminder, technology and innovation based on both patient preference and clinical data—like when patients should take their next dosage—should be carefully developed together to drive program success.

When these three objectives are well orchestrated and connected using both high-tech and high-touch approaches, patients win. Today’s patients expect —and rightfully so—that their healthcare experience will mirror how they can order food or watch a movie. They have access to everything they need at the touch of a device to find the answers they need on their healthcare journey.

As an industry that serves the needs of these patients, we must continue to bring a two-pronged approach to program development. When we do, we will see the results.

We will reap the financial rewards of more patients staying on their prescriptions. We will see more physicians turning to our products and representatives to prescribe medications to their patients. And most importantly, we will see patients and their families living happier, healthier lives as they have better access to medications that will positively impact their lives.

That’s something we can all get behind.

Maria Kirsch is General Manager, Patient Services at 

Three key objectives in building effective support programs