Understanding the importance of promptly starting a patient on specialty medication after it's prescribed is crucial for patients, providers, manufacturers, and pharmacies.However, there are various obstacles that can impede therapy initiation, even after submitting an enrollment form.
Challenges related to access, affordability, and engagement often result in decreased conversions, where patients do not begin their medication regimen. This article delves into common barriers present in each of these critical areas.
Access
Throughout the medication enrollment process, those assisting patients often encounter significant access challenges. Finding, completing, and submitting the correct medication form can be a major hurdle. Submitting a flawless enrollment form can be time-consuming, and inefficiencies can lead to increased costs due to communication gaps, missing information, and incomplete applications.
For instance, when a hub receives a Patient Assistance Program (PAP) form, they typically manually verify patient eligibility through credit checks or income verification. However, streamlining this eligibility check before the PAP submission can reduce rework for all parties involved.
Prior to therapy initiation, it is essential to determine if the prescribed medication is covered by the patient's insurance, which pharmacies stock the medication, and if any additional restrictions are in place, causing delays for teams working to fast-track medication access.
Implementing a unified, automated, and transparent access workflow for hubs, FRMs, providers, and patients can simplify the process and eliminate delays.
Affordability
Alongside access challenges, understanding affordability options is crucial for patient conversion. Lack of affordability or knowledge about lower-cost alternatives can result in non-adherence.
Providing cost information at the point-of-care is vital for patients and providers to make informed decisions. Real-Time Benefit Check technologies can display patient out-of-pocket costs, identify pharmacies, and highlight coverage restrictions, offering stakeholders guidance on necessary support.
Copay assistance and PAP programs can help reduce patient out-of-pocket costs but often involve additional paperwork and time.
Non-profit organizations also provide foundation grants to support patient affordability if patients are aware of these opportunities and apply promptly.
While there are multiple options to assist with affordability, the fragmented nature of these resources can create confusion. Consolidating affordability options into an integrated portal can improve access to support for all stakeholders.
Engagement
Obtaining patient consent is crucial to effectively support patients, regardless of where the enrollment form is sent. While hubs typically collect consent to provide various services, specialty pharmacies may receive enrollment forms without patient consent. Collecting consent upfront at the point-of-care enables manufacturer and hub teams to engage patients with support services, regardless of the form's destination.
Enhanced patient engagement resources play a significant role in supporting patients during therapy initiation and enhancing adherence. Incorporating consent collection into prescribing or enrollment workflows can boost patient conversions and improve health outcomes.
What's next?
Siloed technology systems have complicated the specialty medication onboarding process.Purpose-built ecosystems that unite stakeholders and data to enhance speed-to-therapy and medication conversions can significantly impact population health.Integrated, intuitive, secure technologies that address access, affordability, and engagement collectively are positioned to transform patient access to care. Rather than viewing the enrollment form as the sole hurdle in therapy initiation, taking a holistic approach to the patient journey is crucial.Overcoming interconnected challenges throughout the patient journey is an achievable goal.
English (US)