The specialty patient journey is currently at a major inflection point—and where this all lands will intrigue anyone drawn to the remarkable rise of digital collaboration platforms.
Collaborative SaaS platforms typically use workflows that drive action around a longer-term project instead of a single transaction. As examples, think Figma for product design, Honeybook for event planning, or Angelist for investing. Each of these platforms involves multiple players, plugins, and connections. By combining efforts around a unifying project, service providers can more easily help clients achieve success, which, in turn, benefits their own bottom lines.
Now let’s apply the concept of collaborative platforms to the entrenched and costly problem of patient onboarding and adherence to specialty medications.
There’s a reason that the terminology is called “patient journey.” When patients receive a prescription for specialty medications, they’re not simply headed to CVS around the corner for a single transaction. Rather, patients who are prescribed these complex, specialty treatments must take a series of ongoing steps that are complicated, time-consuming, and quite often frustrating.
In a collaborative platform built around the patient support ecosystem, the unifying project is the patient. Here, patient support providers can place the patient at the center of their collective efforts. No longer will patients be nomads on the outside, relegated to wandering around from call center to call center (if they even bother to seek support at all.) Instead, patients will be on the inside, surrounded by a unified network of different support entities.
As new healthcare infrastructures prioritize collaboration around the needs of patients, the patient journey has the potential to be radically transformed for the better.
Let’s pause for a moment and put this all into context.
The bad news and good news about patient support services
First, the bad news.
The specialty patient journey is broken. We all know that; this isn’t just bad news, it’s old news. Up to 27% of prescriptions and therapies are abandoned costing specialty drug manufacturers $76 billion in lost revenue annually. Despite the colossal amount of resources that pharma is dedicating to fixing this problem, the challenge persists. The vast majority of patients – 84% – do not ever access patient support programs
Now, the first round of good news.
There is a stunning amount of innovation going on within specialty patient services. The space is bursting with creative ideas about how to fix the broken patient journey.
A great example is ConnectiveRx’s award-winning ePA and First-Fill Copay Program. Launched with Teva Pharmaceuticals for their chronic migraine medication Ajovy, the program automatically initiates the PA process within a physician EHR as soon as the patient applies for a copay card. Since PA is required almost 100% of the time, this preemptive measure significantly decreases the time required to get patients’ insurance on board with the therapy.
Or how about Infinitus, which hubs use to automate benefit verification phone calls to payers. Realizing that up to 50% of all calls in healthcare are spent on hold, waiting to deliver repetitive information, Infinitus uses natural language processing, artificial intelligence, and call automation to accurately capture that information without any human answering the phone. Call centers are left to only deal with the edge cases and everyone’s call gets answered faster.
And, PatientBond, which helps health systems decrease readmission rates and increase therapy adherence. PatientBond uses psychographic segmentation and machine learning to target interactions based on the individual’s specific motivations and preferences. This creates an opportunity for multi-channel engagement that delivers truly personalized interventions resulting in real behavior changes.
Also read: What makes for a unicorn in the Rx value chain?
Part 1: CoverMyMeds
Now, for round two of the bad news.
Despite all of this innovation, specialty patient services are enmeshed in silos. And all of the innovation in the world won’t help if it’s tied up in silos. Because the disconnection creates traffic jams in every direction within the patient journey.
Finally, the new good news.
There has been so much attention paid to the silo crisis that the resistance to change is crumbling. The industry recognizes that it must find a way to unlock all the innovation hidden within silos. Something has to give.
And what’s giving is a mindset.
Collaboration benefits vendors, patients, and pharma brands
Life is a collaborative project. As our needs evolve through each stage of life, we seek out different types of support and services to help us through. It’s no wonder that collaborative platforms have skyrocketed to success across so many industries. An individual who needs specific services – for throwing a wedding, for raising kids, for managing a business – benefits from being able to access those services in one place. A business that offers these given services also benefits from having easy visibility and access to customers.
Specialty pharma lives in the same world that has seen other industries embrace the power of collaboration. James Currier spells out this model beautifully in his analysis of market networks,
Some of the seven attributes Currier mentions ring very true around the project of launching a specialty drug: the services involved are complex. Collaboration happens around a project. And they involve a career’s worth of professional connections.
Despite its massive share out of total drug spending, the specialty patient services sector is actually a small, somewhat incestuous industry. It’s a niche where hubs, copay companies, patient assistant vendors, and nurse services often compete for one drug, while collaborating on another.
While it seems counterintuitive, the close proximity of competitors to one another has proven throughout history to increase, not decrease, sales. A network forces competitors to cooperate to a certain degree, with the implicit understanding that they all benefit through increased access to the unifying project. Within a market network, collaboration and competition go hand in hand.
The specialty patient support sector is ready for the same kind of collaboration so that the archaic, heavily manual process of formulating a patient journey to get on a specialty therapy can finally catch up with the digital age.
The project is the patient, specifically the journey of therapy. A single transaction, like copay approval, does not further this journey enough. In order for individual support entities to succeed, the network must succeed. Otherwise, the project – the patient – leaves the journey in frustration. Or never starts it at all.
Also read: Shifts in $283B specialty pharma market
present big opportunities
What does this look like within the innovative but broken patient support landscape? It looks like the new face of HelpAround, a SAAS platform for collaboration amongst specialty pharma support services.
Innovation needs transparency to thrive. Patients deserve to benefit from the innovation that patient support services are ready to offer. And patient support service innovators finally have an open location where they can share. Ironically, by aligning alongside competitors, they gain a competitive advantage.
The future of patient support is here, and it is no longer closed and siloed. It is open and collaborative.