Delivering a Modern Patient Access Experience

Today’s guest post comes from Jonas Boli, Chief Product Officer at Phil, Inc.

Jonas describes the challenges patients face when accessing specialty therapies and explains how patient abandonment affects manufacturers over time. He argues that an effective telemedicine program can help patients via an end-to-end digital experience.

To learn more, register for Phil’s free webinar on August 29th at 2 p.m. ET: Your Guide to Building an Exceptional Telemedicine Program.

Read on for Jonas’ insights.

Delivering a Modern Patient Access Experience
By Jonas Boli, Chief Product Officer, Phil, Inc.

Patients want their healthcare experience to be as seamless as other industries. For biopharma manufacturers, meeting modern consumer expectations can be particularly challenging in a highly regulated environment. Today, getting branded medications is complicated by insurance barriers that create delays, frustration, and a lot of patients never receiving the therapy their doctor prescribed. Successful solutions need to go beyond a friendly user interface to improve prescription coverage and provide affordable, timely access to therapies, while also supporting sustainable biopharma commercialization.

UNDERSTANDING THE MODERN PATIENT

While modern patients prioritize seamless processes that improve access to treatment, they are ultimately driven by the desire to get better and financial realities. Thus, they seek out the path that most easily helps them improve their health, at a price they can afford.

Their perspective is shaped by their increasingly demanding lives and the stress of being unwell while juggling daily life. Accustomed to the 1-click convenience and price transparency offered by modern technology in other aspects of their lives, they want that magic to happen in healthcare too. They expect access to effective treatment to be just as effortless. It isn’t.

THE ROADBLOCKS TO MEDICATION ACCESS

Patients face many roadblocks when seeking to get their prescribed therapy, especially for pricier specialty and specialty-lite medications. Compared to other industries, healthcare is much more complicated. Delivering a seamless patient experience requires the careful alignment of stakeholders, all operating with varying incentives.

The primary obstacle is the growing complexity of payer requirements to get a prescription covered, namely the prior authorization processes. The mechanisms developed by payers to determine whether a treatment warrants coverage can be confusing and take a lot of work, resulting in frustration for patients, prescribers, and pharmacies.

Then there's the problem of misaligned incentives. Even though pharmacists want to do what’s best for patients, pharmacies aren't typically compensated to navigate insurance requirements, so they lack the resources to follow through on PA requests.

The administrative burden on healthcare providers makes the problem worse. Doctors – burdened by heavy workloads – struggle to complete insurance processes while running between patients. Inevitably, affordability and the paperwork burden plays a role in the medication they choose for their patients.

While their prescription works its way through these processes, patients are typically in the dark – they have no clue about what's happening behind the scenes, why it's taking so long to get their prescription, or why it's not covered. This confusion contributes to prescription abandonment, medication nonadherence, and ultimately, the patient remaining unwell.

THE PHARMACEUTICAL MANUFACTURER'S DILEMMA

Manufacturers take on huge risks during drug development, investing years in research, clinical trials, and FDA approval before bringing it to market. The R&D costs are large, and until the drug reaches the patients who need it at scale, the manufacturer is deep in the red financially. Ensuring commercial success to recoup these costs requires that patients can actually get the therapy and get it covered by insurance.

The delicate balance between ensuring patients get the treatment they need and making new drug development sustainable from a business perspective is the reality that all manufacturers face. They must strive to create a sustainable ecosystem that supports scientific innovation and easy medication access for patients. Without meaningful access, the societal benefits of groundbreaking science go unrealized. At the same time, if manufacturers over-subsidize access, their continued scientific investment in new therapies is unsustainable.

MAKING THE MAGIC HAPPEN

For commercial success, manufacturers need to prioritize strategies that result in a modern and economically viable patient experience. Phil helps manufacturers create sustainable growth with an innovative, digital hub that enables them to:

• Help patients get access to medication. Digital tools powered by real-time data help manufacturers quickly respond and adapt to access roadblocks, ensuring patients can quickly initiate and stay on therapy.

• Take a dynamic copay approach. Rather than setting a single fixed copay design, we help manufacturers adjust prices based on patient accessibility needs. This approach benefits both patients and brands, so teams can make the most of their financial assistance programs.

• Give patients transparency in the medication access process. Providing patients with more transparency using real-time information on prescription status, including prior authorizations, making it easier for them to adhere to treatment.

• Personalize the patient access journey.
While a user-friendly interface is beneficial, the primary objective should be making access to therapy easier so patients can reach their goal of getting better. With PhilRx, manufacturers configure dispense workflows that respond to each patient’s insurance plan to help them get medication quickly.

Another key component of a modern patient experience is offering a virtual access channel. Learn how you can build a telemedicine program that delights your patients and delivers an end-to-end digital experience by joining our free webinar on August 29th at 2 p.m. ET: Your Guide to Building an Exceptional Telemedicine Program.

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