Prescription adherence is healthcare’s $289 billion problem. After spending many years and an average of $12 million to bring a potentially life-saving drug to market, manufacturers have a vested interest in getting products in patients’ hands and keeping them there. But it’s not so easy.
Patients fail to fill or refill medications for a variety of reasons. Some will discontinue treatment because they don’t like the idea of being on medication indefinitely or experience side effects. Others, due to delays in getting product, will switch to a competitor before ever trying the drug. With insights into these types of problems and their causes, manufacturers can take action to eliminate obstacles to therapy and take a bite out of the adherence problem.
A data-centered approach that provides actionable insights to specialty pharma product brands can ensure that therapy gets to patients quickly and efficiently, and remains in the hands of those who need it.
Patient-level data collected by specialty pharmacies carries the raw information that can be turned into insights into patient journeys. Longitudinal data related to patients, their prescriptions, prescribers, and insurance companies provides a look into obstacles both at a system-wide basis and at the patient level.
Common hurdles leading to delay in getting medications include financial need, payer denial, and complexities related to insurance forms for benefit verification, prior authorization or appeals. Armed with that knowledge down to the territory level, manufacturers can send patient access reps to the field with specific action items. They can educate prescribers on insurance requirements, put financial bridge programs in place where needed, and focus sales reps on prescribers that have high numbers of patients waiting for product.
Managing Data and Ensuring Privacy
Navigating the data and figuring out how to use it efficiently, however, is not an easy task. Not only is it difficult to identify which specific fields will produce meaningful metrics, but the raw data is rarely in a readily-usable state.
Best-in-class data aggregators, as trusted third parties, have strong relationships with specialty pharmacies and work with them daily to improve raw data entering reports, resulting in superior insights.
They intake the data, cleanse, de-identify and aggregate it, then report it back to manufacturers for review. They strip Personal Health Information (PHI) of names, contact information, social security numbers or anything that might identify the patient, in compliance with HIPAA regulations. Teams of statisticians regularly evaluate whether combined data sets can be re-identified and remove identifying records accordingly.
Not All Pharmacies Perform the Same
Specialty pharmacies do not all perform equally. The time it takes them to fill prescriptions and the duration a product stays in a patient’s hands can differ significantly. The knowledge of best and worst performers can enable a brand to maximize their distribution network, keeping those specialty pharmacies that best serve their patients, compensating for data accurately, and putting additional patient support services in place if needed.
While problem of patient adherence program isn’t likely to be solved in the near future, manufacturers can, through data-driven insights, improve the journey by removing obstacles facing their patients.