Although specialty therapies have the potential to help people live healthier lives, their cost and complexity can create distinct challenges.
Specialty medications have become the fastest growing, largest segment of the total pharmacy market with innovative treatment options for cancer and a variety of chronic diseases. In fact, it’s estimated that 65% of newly launched medicines within the next 4 years will be specialty medications.1
With a promising pipeline of specialty therapies and more patients using them, we must look for ways to improve the journey patients navigate to access, afford, and adhere to these complex medications.
Although specialty therapies have the potential to help people live healthier lives, their cost and complexity can create distinct challenges. Let’s look at the case of Brandi Bryant, who was diagnosed with non-small cell lung cancer at 39 years of age.
Seeking information about her diagnosis and treatment options, Bryant asked her oncologist about a targeted therapy but acquiesced when her physician encouraged her to pursue traditional chemotherapy and radiation. After being hospitalized when her disease progressed to stage 4, Bryant joined an online support group, which helped her advocate for herself and push for targeted therapy.
Six weeks later, there was no evidence of disease and though she had lingering effects from her 30 rounds of radiation, Bryant reveled in her progress: “I could breathe again.”
Bryant’s story demonstrates that many patients struggle with finding and interpreting information on their condition and treatment after receiving a diagnosis. The experience for patients starting a complex therapy can be equally challenging.
Patient-centric support powered by health care technology is critical to help people navigate their treatment journey and improve outcomes. It can also benefit care teams by automating and simplifying the access process—contributing to a 34% reduction in time to therapy in some cases.2
With 1 in 5 patients experiencing delays in getting their medications because the cost was unaffordable,3 financial barriers remain a significant issue for patients. However, the biopharma industry provides patients with a variety of affordability assistance options. For example, 20% of patients participate in a financial support program. Further, patient assistance programs have helped more than 36 million patients obtain their medications in the past decade.4 Despite these efforts, we found that more than one-third of patients were unaware these programs existed.5
Bryant’s experience of proactively finding support for her treatment plan and health care inspired her to become a patient advocate. But many patients don’t have this support or don’t know where to find it.
In one study, just 16% of patients were aware of services designed to help patients access, afford, and adhere to their therapy.6 As a result, most patients navigate their treatment plan without support.
The complex process can even leave some providers confused without clear options to help connect their patients to available assistance. That means the burden of managing adverse effects, tracking care costs and insurance, and maintaining adherence falls squarely on patients.
But it doesn’t have to be this way. Solutions exist today that simplify the prescribing process and enable providers to enroll patients into support programs at the point of prescribing. This can help improve the prescribing process for patients and care teams alike.
We know that patients today expect greater visibility into their treatment journey. But patients often don’t know who on their care team is responsible for various aspects of their treatment and don’t understand why they don’t automatically receive an update when something changes with their case.
As a result, more than one-third of patients report spending more than 3 hours on the phone, sharing information and asking questions among insurance companies, pharmacies, and providers.7 In an environment when your dinner order can be tracked from the restaurant to your front door, it’s natural for patients to want similar transparency in something as important as their health care.
Care teams benefit from visibility as well, enabling them to anticipate and address challenges patients face—from access and affordability issues to adherence barriers. Connecting a patient’s care team through technology can help identify where a patient may be hung up and how to help keep them moving along their health care journey.
Creating solutions that provide visibility can help address patient expectations for transparency and convenience. They also hold potential to enable patients to better manage their medications and become more informed and involved in their treatment.
For example, smarter solutions integrated with electronic health records can help patients move beyond simply seeing appointments and test results by layering in more detailed medication information and connecting patients and care teams.
Although patient-centered technology can power hub programs, the importance of dedicated human support is more important than ever. Providing patients with ongoing education—such as injection training—and adherence support can help pave a path to better outcomes.
For Brandi, research and self-advocacy helped her beat the odds of her diagnosis. But, she admits that each new medication, test, or appointment means she has more work to do to manage her treatment.
“I think the health care system could use technology in a much better way. Please make things easier for patients. When people are feeling so bad, and you still have all of these obstacles that are impeding you just trying to get better…it’s distracting you from the ultimate goal of feeling the best you can,” Bryant concluded.
About the Author
Vicki Muscarella is the vice president of specialty product at CoverMyMeds. She has more than 25 years of experience in architecting, developing, and supporting highly scalable, reliable software products. Her passion lies in leading technology teams to produce quality solutions that delight customers. She believes the adoption of agile practices is the answer to delivering value-driven, customer-centric results as quickly as possible.