As innovative treatment options for cancer and a variety of chronic diseases, specialty medications have become the fastest growing, largest segment of the total pharmacy market.
In fact, within the next four years, 65 percent of newly launched medicines are expected to be specialty medications. With a promising pipeline of specialty therapies and more numerous patients who utilize them, we need to look for ways to improve the journey patients navigate to access, afford and adhere to these complex medications.
While 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.
I could breathe again.Brandi Bryant, 43
Seeking information about her diagnosis and treatment options, Brandi asked her oncologist about a targeted therapy but acquiesced when her doctor encouraged her to pursue traditional chemotherapy and radiation.
After being hospitalized when her disease progressed to stage 4, Brandi 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, Brandi reveled in her progress: “I could breathe again.”
Brandi’s story demonstrates how patients sometimes struggle with finding and interpreting information on their condition and treatment after receiving a diagnosis. Starting a complex therapy can be equally challenging.
Patient-centric support powered by healthcare 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 percent reduction in time to therapy in some cases.
With 1 in 5 patients experiencing delays in getting their medications because the cost was unaffordable, financial barriers remain a significant issue for patients.
The biopharma industry has responded with a variety of affordability assistance options for patients. Twenty percent of patients participate in a financial support program, while patient assistance programs have helped more than 36 million patients obtain their medications in the last decade.
Despite these efforts, more than a third of patients were unaware these programs existed.
More than one third of patients are unaware prescription affordability programs exist.CoverMyMeds Patient Survey, 2020
Brandi’s experience of proactively finding support for her treatment plan and healthcare inspired her to become a patient advocate. But many patients don’t have this support or know where to find it.
In one study, just 16 percent of patients were aware of services designed to help patients access, afford and adhere to their therapy. Said another way: 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 sometimes leaves the burden of managing side effects, tracking care costs and insurance and maintaining adherence to patients.
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. Doing so can help improve the prescribing process for patients and care teams alike.
Patients today expect greater visibility into their treatment journey, but they often don’t know who on their care team is responsible for various aspects of their treatment. And they don’t always understand why automatic updates aren’t available when something changes with their case.
As a result, more than a third of patients report spending more than three hours on the phone, sharing information and asking questions among insurance companies, pharmacies and providers.
In an environment where 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 healthcare.
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 stuck and how to help keep them moving along their healthcare journey.
Please make things easier for patients. When people are feeling so bad, and you still have all these obstacles impeding you … it’s distracting.
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, by layering in more detailed medication information and connecting patients and care teams, smarter solutions integrated with EHRs can help patients move beyond simply seeing appointments and test results.
While 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 on her diagnosis. But each new medication, test or appointment means she has more work to do to manage her treatment.
“I think the healthcare system could use technology in a much better way,” Brandi said. “Please make things easier for patients. When people are feeling so bad, and you still have all these obstacles impeding you just trying to get better … it’s distracting you from the ultimate goal of feeling the best you can."
To learn more about how patients with specialty conditions access, afford and adhere to their medication, read the 2021 Medication Access Report: Complex Care and Specialty edition.