How patient services are redefining the patient relationship

Beyond-the-pill began trending a few years ago as an attempt to use technology-driven tools and services to solve for undifferentiated products and find new sources of revenue. As the thinking went, if pharma could wrap a pill with a set of digital apps and charge for them, it might be able to enhance its value among HCPs and payers. GE’s evolution from products to solutions was referenced as an exciting case study.

The reality didn’t work out that way. There were no new revenue models for pharma on the scale of selling drugs. The benefits of sensors and apps as new standalone products or services were anecdotal at best and certainly not short-term. And as many brand marketers discovered as they watched their peers move up through the organization, joining a digital innovation team in pharma was not always a great career move.

Around the pill

At the time, I argued that a better framing of the goal was not to move “beyond the pill” but to enhance opportunities “around the pill.” Identify personalized services that would enable patients to have better experiences with their therapy regimen and hopefully better clinical outcomes. Keep the pill or therapy in the center of the value proposition, not on the side.

Here we are a few years later and the world of medicine has continued to evolve. As innovation teams were busy running hackathons trying to find new revenue adjacencies, the real innovation began spilling out of the R&D labs of early-stage biotech, genomic and gene therapy companies. New specialty products addressing rare diseases started filling the docket at the FDA.

This renaissance in product development is breathing new life into the industry, leading to one of the strongest periods of life science investment and M&A in a long time. But the cost and complexity of these new life-giving drugs are also presenting a new set of access challenges for patients.

Are patient services a better strategy for around-the-pill investments?

Patient services investments are growing, but…

Currently about 52 percent of pharmaceutical companies spend money on extended patient services, and Accenture predicts that within the next 18 months, that will increase to 84 percent.

Despite the interest, however, only 44 percent of pharma companies feel their technology is strong in this area.

Pharma companies who outsource their patient services to hub services companies are often frustrated at the quality of service their patients receive, but when they try to bring the work in-house, it doesn’t always receive the senior executive attention or investment it deserves.

Building a patient hub can be a huge investment for a small orphan drug company with just one or two products and just a few hundred patients on therapy. Therefore, whether the decision is to build or outsource, clear objectives and a laser focus on what will demonstrably enhance patient experience is necessary.

How should pharma prioritize its investments in patient services?

Defining a patient services program

We see newly diagnosed patients overwhelmed with all the information they are expected to process. The emotional and financial anxiety of how they will get access to treatment and adjust to their new reality can be more troubling than the diagnosis itself. When we talk to patients, we hear three distinct areas for investment to support an effective patient services program.

Disease education

Disease education tops the list. According to Pew Research, 80 percent of internet users look online for information about specific diseases or medical problems. With the complexity of new biological and combination therapies, patients are looking for better and more comprehensive explanations of the disease itself and the role of the therapy.

Investments in disease education start with making the patient website relevant and understandable, not just promotional. The website needs to be in a language that patients understand, that demonstrates empathy and that clearly articulates the patient and disease journey. The use of animation and video is obvious, and access to online nurses and case managers or social services for additional education and support for patient adherence is a table-stakes expectation.

According to 2017 research, 86 percent of oncologists believe these types of education and adherence programs can help improve patient outcomes.

A commitment to social media and support of an online patient community to encourage peer-to-peer support is important. Extended patient support communities such as Imerman Angels provide a very valuable role in supporting patients during the early days and weeks of diagnosis and treatment. These third-party support communities should be considered as a part of a broader patient services strategy.

Product access

A close second on a patient’s wish list is access to the product itself. Reconciliation between the diagnosis, prescription and treatment is critical. It is one thing to influence the treatment decision and get a prescription written but quite another for the patient to successfully receive insurance coverage and start the treatment in a timely manner. Each year, 300 million prescriptions are rejected by insurance companies has a result of prior authorization (PA).

Facilitating prior authorization is a core function of patient hub services. Most new biologics require prior authorization from the insurance company, requiring a lot of paperwork before the insurance coverage will be approved. A patient services platform can help streamline the effort. Platforms such as CoverMyMeds, a subsidiary of McKesson, specializes in automating the PA process.

When an insurance plan doesn’t cover a drug in its entirety, there may be other programs within pharma that allow access to that drug. Patients would benefit from a one-stop shop where they can get access to this information and service.

Personalized services

Third, while digital tools, data and automation are all key components of patient services, there remains an important role for personalized case management.

The most successful hub services platforms provide knowledgeable and empathetic case managers to support patients throughout their treatment journey. They help to accelerate the onboarding process and manage the PA decision and can arrange for basic services such as transportation to infusion centers for treatment.

Patient-first strategy

Patient services are a core element in a patient-first strategy, and companies will need to make significant technology investments in information and support systems to support the patient experience. It is not enough to just create a host of one-off services and expect patients, their caregivers and HCPs to figure it all out. Research shows that 76 percent of patients expect pharma to provide them with tools and services. The tools and services offered must be coordinated and customized to move an organization from one simply focused on patient services to one truly committed to the customer experience.

And once the services are in place, a concerted effort to educate both healthcare professionals and patients is very important. Only 19 percent of patients are even aware of services available to them.

Whether a brand team elects to outsource their hub services or build it in-house as a core capability, keeping the focus of the team on patient needs is critical.

For many of the newest and most powerful drugs coming to market, this patient-first orientation cannot be simple lip service. It must be given a full seat at the brand planning table and receive a level of investment concurrent with its importance to the success of the brand and the health of its patients.

This focus on a patient-first strategy suggests that even an “around-the-pill” strategy is not good enough.

We need to move to an “around-the-patient” strategy.