David discusses how common medication access, adherence, and affordability barriers can lead patients to abandon important therapies. He suggests that technology can connect providers with actionable information at the point of care, thereby giving patients access to data that can lead them to make better decisions.
To learn more, download CoverMyMeds’ 2021 Medication Access Report: Healthcare Technology Edition.
Read on for David’s insights.
Expanding Healthcare Technology Across the Care Team to Improve Medication Access
By: David Holladay, President, Access & Adherence, CoverMyMeds
Despite good insurance through her employer, each infusion came with a $6,500 copay—a price, she decided, was too steep. On top of the drug’s high cost, it was also an inconvenient administration method.
“I don’t know how people can afford to be sick and still live their lives,” she said. “So, I opted out. I canceled (the infusion).”
Patients like Patricia are more likely to abandon specialty therapies than any other drugs during the deductible period of their insurance—possibly leading to worsening conditions and future hospitalization. (See: Medicine Use and Spending in the U.S.: A Review of 2018 and Outlook to 2023, IQVIA, 2019)
The risk holds true for patients not on specialty therapies, too. That’s because important details like medication options, formulary and benefit information and affordability options aren’t always available at the point of prescribing. Often these variables aren’t considered until the patient arrives at the pharmacy, which may be too late for 50 percent of patients who abandon their medication when it cost too much. (CoverMyMeds Patient Survey, 2018)
Patients face many challenges when it comes to accessing, affording and adhering to their medications. In their pursuit of helping patients, many providers and pharmacists experience an inefficient, disjointed workflow that can get in the way of the patient care experience.
However, interoperable, automated healthcare technology could improve care team frustrations and patient health outcomes.
For instance, tools that offer prescription decision support available earlier in the patient journey can help patients avoid sticker shock and consider coverage options at the pharmacy (or point of administration in the case of specialty therapies). These solutions provide timely information—such as formulary and benefit information, affordability options, medication options, adverse interactions between two or more medications, and prior authorization (PA) requirements—allowing care team members, including the patient, to have informed medication conversations at the point of prescribing.
As we’ve learned from our connections to over 750,000 providers, this information needs to be delivered at the right time and within the preferred channel for their care team.
EQUIPPING PROVIDERS AND CARE TEAMS WITH TECHNOLOGY TAILORED TO THEIR WORKFLOW
Integrations such as real time prescription benefit (RTPB), electronic prior authorization (ePA) and even programs that surface drug-specific information within workflow help create a trusted technology experience for all care team needs—before, during and after prescribing. Since the prescribing process isn’t always linear, solutions should also work to surface information when and where it’s needed.
For these tools to work well, they need to be effective and accessible to members across the patient’s care team. For example, nurses are often tasked with researching and validating medication information such as history of tried and failed drugs, prescription benefit details, financial assistance resources and copay. However, most care team members must use multiple online resources to find this information. (CoverMyMeds Nurses Survey, 2019.)
Integrated technology can help care team members find and select information specific to their role in an unobtrusive way—helping to avoid information overload and alert fatigue while also filling information gaps with end-to-end patient-specific data. For providers, solutions like RTPB tools can surface patient-specific benefit and pricing information and even proactively initiate a PA request if one is needed for the prescribed medication. In fact, patients were 19 percent more adherent to picking up their medication when providers used a reliable, accurate RTPB solution to determine the most appropriate medication access options. (CoverMyMeds Case Study: Improving Prescription Decision Support with RxBenefit Clarity™, 2019)
Interoperable electronic tools specialized by position create a delineated, connected workflow and reduce time spent tracking down information such as drugs on formulary, remaining deductible and medication history.
Accessing this vital information is particularly important in a post-pandemic world. Fewer drug representatives have visited providers’ offices since the COVID-19 pandemic began, leaving many providers in the dark about new therapies on the market, or changes to the ones they did know. This is where biopharma companies can collaborate with technology organizations to deliver brand-specific information within a provider’s workflow, helping to save care teams time digging for updated drug information or searching for new therapies.
Patients should also be empowered members of their own care team. The tools we’ve built for patients are designed to complement care team technology, including surfacing transparent updates on where their medication is within the PA process. Patients can also evaluate the cost of their prescription and access available prescription discount cards to help afford their medication.
COMPLEMENTING TECHNOLOGY THAT PUTS PATIENTS AT THE CENTER
Integrated technology solutions can help increase care team job satisfaction and improve patient access, affordability and adherence outcomes by alleviating common time-intensive administrative tasks. This can be especially valuable for patients like Patricia who manage complex conditions and need our help getting the medicine they need to live healthier lives.
To learn more about technology’s role in connecting providers with actionable data at the point of care, read our newly published 2021 Medication Access Report: Technology Edition.
Those attending HIMSS21 can attend our presentation, “Utilizing Technology to Improve Medication Access Barriers,” on Aug. 13 or schedule time to meet with us to learn more about our access, adherence and affordability solutions.
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