From Prescription to Patient: Four Ways to Increase Speed to Therapy

Let's start with an alarming pair of statistics. First, 40% of specialty product prescriptions actually get filled, and second, when a patient’s copay or out-of-pocket cost exceeds $250, the abandonment rate is nearly 70%.

Pharmaceutical manufacturers are focused on making massive investments in product launches, field force training, marketing, and healthcare provider (HCP) education, but what happens to that momentum once the prescription is written and it is in the hands of the patient to fill? The disconnect in the level of pre- and post-prescription focus is easy to understand because the complexities of each require wildly different solution thinking. Across the specialty medicine market, we are seeing that unaddressed post-prescription issues have serious impact on patients, prescribers, and the pharmaceutical manufacturers that serve them.

Once a specialty prescription is written, fulfillment can become derailed at any number of points in the process. It can be helpful to look at these roadblocks and the key strategies for reducing or eliminating prescription abandonment under the framework of “the 4 Es”: enrollment, engagement, entry point (or access), and execution (or delivery).

Enrollment strategy

Reducing friction in the hub enrollment process is the first step in helping patients get and stay on their therapy. Meeting HCPs in the electronic health record (EHR), where they spend a large percentage of their day, can vastly improve speed to therapy. Allowing HCPs to access key features and data without leaving their familiar in-EHR clinical workflow means they don’t have to switch between different applications, reducing the time to enrollment and the risk of data entry errors since the patient information is already there.

As non-commercial pharmacies (NCPs) are increasingly integrated into hub enrollment strategies, the EHR as a mechanism for enrollment is more common. For self-administered products covered under pharmacy benefits, including treatments such as oral therapies, self-injectables, and self-administered drugs, the NCP can serve as a valuable enrollment channel.

In these situations, HCPs don’t need to enter the patient data because it is already in the EHR, and the relevant information (i.e., diagnosis codes, demographic data, etc.) is automatically transferred to the prescription. In-workflow EHR prescribing can give patients access to the medication days or even weeks faster. The time HCPs would normally have spent dealing with enrollment can now be used where it belongs, with their patients.

In addition, digital portals can streamline documentation submission by providing a centralized platform where HCPs can upload, access, and manage patient information.

This eliminates the need for paper forms, manual data entry, and faxing—and ultimately leads to improved accuracy and communication.

Engagement strategy

Technological advances are helping put patients at the center of their care more than ever before, enabling them to become more actively involved in making decisions about their treatment instead of passively receiving care.

Among the tools that are available to patients are mobile-first solutions that can help boost adherence while giving pharmaceutical manufacturers more information about the types of support patients want most. Best-in-class offerings include text-to-enroll capabilities, digital communication channels for updates and reminders, and patient self-service options through mobile platforms.

Leveraging patients’ reliance on their phones as a first stop for information, mobile care platforms can connect in a single place the individual silos that are supporting them. Funneling everything through one service to keep patients well informed benefits not just them and HCPs, it also gives brands more leverage to incorporate the best option for each of those silos.

Engaging different generations of patients, including both digital natives, such as Gen Z and Millennials, and older generations, who are not as familiar with digital platforms, is an important aspect of a pharmaceutical manufacturer’s engagement strategy for their brands. To address the widest range of patient needs and preferences, an effective engagement strategy should incorporate both traditional and digital channels.

Entry point (or access) strategy

With prescription drug pricing as volatile as it is today, never has an access strategy been more important in helping patients start and stay on their medication. If they haven’t already, pharmaceutical manufacturers should develop comprehensive programs that make their brands available, affordable, and easily obtainable.

An effective access strategy should include a number of key elements, including:

• Effectively addressing prior authorizations (PA) denials. Pharmaceutical organizations should leverage technology, including electronic PA and real-time benefit verification systems to streamline processes; build strong relationships with payers; educate HCPs about specific PA requirements; and monitor denial trends—with the ultimate goal of minimizing the strain on HCPs and reducing speed to therapy for patients.
• Bridge programs. These programs often provide a lifeline for patients who otherwise cannot afford their prescribed medications. They deliver a temporary free supply of medication to the patients while hub agents work through coverage restrictions and then seamlessly transition the patient from bridge to commercial product once coverage is obtained.
• Copay support integration. Seamlessly connecting a copay support program with a patient’s insurance plan allows the dispensing pharmacy to automatically calculate the patient’s out-of-pocket cost and apply the discounted price.

Execution (or delivery) strategy

Developing a smart execution strategy that ensures patients receive and start therapy is critical to improving adherence. Providing patients with tools that allow them to track the progress of their prescription, including patient engagement platforms that feature “pizza tracker”-style visibility, offers ways to further engage patients in their own treatment. Offering visibility into the fulfillment process, not just for patients but for all stakeholders, can increase engagement, loyalty, and, ultimately, adherence.

Pharmaceutical manufacturers that place as much focus on their patients’ post-prescription journey as they do on pre-prescription brand marketing and sales efforts are likely to be rewarded with more engaged patients and increased adherence. Using the 4 Es as a framework for combating prescription abandonment, companies can evaluate their current approach and determine if changes need to be made.

- Kristine McGaughey, Vice President, Implementation at ConnectiveRx, contributed to this article.

About the Author

Chris Dowd is Senior Vice President, Market Development, at ConnectiveRx. With a nearly 30-year career spanning leadership roles across Big Pharma, healthcare startups, and the patient support space, Dowd is a preeminent industry voice in patient access and adherence.