Survey: Medication Access Impacts Initial Therapy Choices for Some Patients

Oncologists and rheumatologists reported the highest costs to their practices at $6700 and $7900 per month, respectively.

A survey of physicians found that challenges with accessing medications can have a significant impact on therapy choices, with respondents indicating care plans are impacted for up to 33% of patients.

The survey of 102 specialist physicians highlights how inefficient access pathways negatively impact patient care, according to a press release from OptimizeRx. On average, the survey found that physicians would make a different therapy choice for 33% of patients if medication access was not a factor, and physicians said they had to change treatment plans for 26% of patients due to access challenges.

The survey also highlighted the time involved and the financial cost to physicians’ practices to initiate specialty medication. Technology solutions within the electronic health record (EHR) could help mitigate these problems.

“Pharmaceutical manufacturers devote significant resources to ensure patients are able to have access to life-changing medications, yet this survey shows that patients are still not always getting access to treatments they need,” said Karina Castagna, senior vice president of access solutions at OptimizeRx, in the press release. “This snapshot should prompt manufacturers to take a closer look at how prescribing burdens on physicians may limit a patient’s ability to get started on their doctor-preferred first choice of therapy.”

Physicians often struggle with the time taken, cost incurred, and resources necessary to initiate medications for patients, particularly for specialty brands. The survey found that 69% of physicians ranked the process of starting patients on a specialty medication as very or extremely difficult.

On average, respondents said they and their staff spend nearly 4 hours a day helping patients access medications, with an estimated cost to the practice of $5800 per month. Dermatologists, gastroenterologists, and neurologists reported spending 5 or more hours per day helping patients gain access, whereas oncologists and rheumatologists reported the highest costs to their practices at $6700 and $7900 per month, respectively.

Although there are digital tools available to help streamline the therapy initiation process, they are not yet a consistent part of pharmaceutical manufacturers’ market access strategies, which limit patient access to therapies. The survey specifically noted that physicians want more transparency around formulary coverage and preferred pharmacy information.

Of the 102 respondents, 60% said they do not have real-time access to patients’ insurance benefit information, although 71% of physicians who do have access to this information said they check it before writing a specialty prescription. As a result, just 39% of physicians routinely talk to patients about affordability options. Notably, 74% of surveyed physicians do not have a way to know whether a patient has filled their prescription.

When asked to identify specific technology solutions that would be helpful in their EHR systems, several tools were ranked as “extremely helpful” or “very helpful” by the respondents. Specifically, 84% said a tool to file prior authorizations more easily would be helpful, 83% identified a solution to help patients access co-pay presentations, 81% identified a tool that automates the specialty or hub enrollment process, 78% said they wanted prescription benefit information, and 74% said they wanted to receive a notification with a patient did not fill their prescription.

“Enabling efficient digital market access strategies is critical to easing physician prescribing burden,” Castagna said in the press release. “EHR-based solutions present new opportunities for market access teams to streamline prescribing and therapy initiation processes, reducing the impact market access challenges have on treatment choice.”

REFERENCE

Surveyed physicians say access challenges impact their care plans for up to 33% of patients. News release. OptimizeRx; April 20, 2022. Accessed April 21, 2022. https://investors.optimizerx.com/news-releases/news-release-details/surveyed-physicians-say-access-challenges-impact-their-care