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Patient Access and Affordability Support in an Era of Virtuality

September 19, 2020 by Laura Kohler0

Today it’s more important than ever to help ensure that consumers can access and afford their medications. With the emergence of a global pandemic, what strategies and technologies can pharmaceutical manufacturers implement to help simplify and streamline the access process for consumers?

The effectiveness of a pharmaceutical manufacturer’s access and reimbursement support program will have a direct impact on patients’ ability to access and afford their medications. Here are a few examples of difficulties providers and patients have cited:

  • 90% of providers [mentioned] PA-related delays in patient care and 28% reported that such delays have led to serious adverse events for patients
  • Of more than 500 specialty patients surveyed, 60% claimed that they had some difficulty in receiving their first dose of specialty therapy, and 76% reported their personal role in coordinating care activities as “involved” or “very involved” (covermymeds.com Patient and Provider Surveys, 2020)
  • Patients describe the time and effort required to start a specialty therapy as a full-time job – citing upwards of 30 phone calls to various healthcare stakeholders and many hours gathering information to obtain coverage (Simacek KF, et al. The impact of disease-modifying therapy access barriers on people with multiple sclerosis: mixed-methods study. J Med Internet Res. 2018;20(10):e11168)
  • 60% of program enrollment forms are incorrectly completed, resulting in product access and reimbursement program delays (covermymeds.com)
  • 40% of new prescriptions are not filled because of the time it takes to complete a patient’s Benefits Investigation (BI)/Benefits Verification (BV) or ePrior Authorization (ePA) (covermymeds.com)

What can pharmaceutical manufacturers do to help ensure patients can access and afford their products in an efficient manner, especially during a global pandemic? Below are six key actions and considerations:

  1. Perform a strategic assessment

What does the program offer, and how does it compare with others in the category and industry? What does “good” look like? How can we improve and streamline the processes? Answers to these and other questions can come through competitive program audits, market research, internal stakeholder and customer needs assessments, and audits of existing resources and enrollment forms.

2. Evaluate and refine branding

Is the program visually simplified for easy recognition by patients and physicians alike? Visual complexity with misaligned branding and resources can impede program identification and equity. To achieve optimal program branding, manufacturers can apply brand values and positioning to create a compelling program name, logo, and campaign. Ultimately, brands need to develop a verbal and visual identity with style guidelines for all stakeholders to follow.

3. Audit and streamline communications

How many different resources have been created over time, and is there consistency in the message? What can we do to simplify the message and streamline the story? By following the patient access journey, manufacturers will be better informed when developing appropriate and effective online communications, including education and awareness resources, and creating or streamlining enrollment forms, reimbursement support tools, and copay and voucher resources.  This approach can also help inform virtual convention planning.

4. Ensure optimal operational program configuration

Who are all the different stakeholders and partners? Are they aligned to the common goal and working like a well-oiled machine, or are there opportunities for improvement and enhancements? Are you leveraging electronic health record (EHR) and Telehealth technology (see Figure 1) to optimize processes as well as access and affordability messaging opportunities? To find answers, manufacturers may want to perform vendor assessments, explore optimal program architecture, and seek ways to automate the BI/BV/PA processes. They may also want to explore how best to integrate software – including the EHR platforms – and aggregate data to help inform broader strategies.

Figure 1.  EHR and Telehealth access and affordability engagement opportunities

5. Gain insights through data and analytics

How is the program performing? Are patients getting their prescriptions filled in a timely manner? What are some of the challenges that need to be addressed? We can get answers to these questions by conducting baseline analytics to start with, defining and measuring performance metrics, integrating and analyzing data, and assessing adherence and outcomes.

6. Ensure all stakeholders are fully educated

How comfortable are your sales and reimbursement reps with talking about access and affordability and your program offerings? What resources can they leverage to help them successfully engage? Maybe an implementation guide can help, along with some virtual training and annotated resources and roadmaps. Do doctors and practice staff understand the full scope of your offering? Does your audience know who to reach out to? Are they aware of all the online resources available to them? Are they aware of your product’s current formulary access? How can we best communicate the access and affordability? What nonpersonal technologies can we leverage for communication and what are the optimal messages in those channels? 

In an era of virtuality and a global pandemic, all of the above become mission-critical to patient access and affordability, and ultimately, to a brand’s success. Understanding the holistic picture and how all these considerations work together will empower physicians to prescribe with confidence, patients to more easily access and afford their medications, and pharmaceutical manufacturers to maximize adoption, preference, and loyalty for their brand.

Laura Kohler


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