In the last column, Drill Down focused on a holistic approach to understanding the Patient Journey. This month, we will drill deeper to help you evaluate ways to take advantage of opportunities identified in your research.
Once you have done patient journey research for your brand and identified specific leverage points, i.e., places along the patient path where intervention might affect outcomes, you can alter the journey to improve the patient experience and benefit your brand. We will examine several segments of this journey that present unique opportunities to influence the patient experience.
Presentation and Diagnosis
Some conditions go undiagnosed for long periods, leading to continued patient suffering and perhaps the wrong treatment. One strategy for a brand is to influence the rate of diagnosis by educating consumers and practitioners alike. Secondary data can assist with targeting physicians with the highest potential to increase testing or diagnose conditions when used to understand a physician’s practice and current activity. Physicians with a higher population of target patients—by age, gender, comorbidities or common misdiagnoses—will make the best physician targets, especially those who are not already high testers, diagnosers or treaters.
In Figure 1, using secondary data to identify docs with low volumes of new patient starts and a high share of targets allows us to grow the market by identifying where messages might be honed to drive more testing or education on diagnosis.
From a patient perspective, DTC marketing is tried and true. Today, with deeper and wider data available to understand your consumers, the promotional dollars aimed at your target population can be more precise than ever before. Expanded access to consumer demographics, psychographics and media preferences or use—along with broader and deeper clinical data—lead to a level of precision in targeting consumers with the right message in the right location that was not possible several years ago.
Once treatment is selected and the physician prescribes, new patients—particularly for expensive specialty drugs—often need to overcome hurdles to access the medication. Hurdles include cost pressures when the medication is too expensive, or payer blocks.
Let’s look at a common practice: Requiring a Prior Authorization (PA) before dispensing. A recent analysis by Symphony Health Solutions revealed approximately 5% of patients who submit a claim for “Brand A” are initially denied due to a PA requirement.
Many patients eventually get the drug, but the risk is that the patient or the prescriber tires of the inconvenience and moves on to another brand. With denials what they are, this presents a great place to intervene and ensure patients can access your brand quickly and efficiently. For example, when we drill deeper we see:
- 34% of the patients overcame PA and obtained the product within seven days of the initial denial.
- 48% obtained the product within 15 days and 58% received the product within 30 days of the initial submission.
- 42%, however, did not have the brand at the end of one month following the initial PA.
What’s also interesting: 7% of all prescribers had patients that fell into this last group, and 38% of all prescribers that had at least one denial with a PA fell into this group. Patients can often be managed by their physicians, so getting to the physician’s office early to ensure they are effectively navigating the PA process is key.
Understanding where patients get condition information—as they become aware of symptoms and immediately following diagnosis—also provides an intervention point. CRM programs designed to get the patient to the doctor to seek treatment have been around a long time. What is different: The robustness of the data, which allows a brand manager to monitor the patient’s progress along the way. You no longer need to wait six to nine months to look at conversion—and even longer for adherence. Today, you can easily monitor whether your CRM leads get to the doctor in a timely fashion and whether that office visit triggered treatment.
Therapy Progression, Switching and Adherence
One of the brands we examined has an issue with therapy drop-off at about the 90-day mark. If this is your brand or your brand is the competitor, being able to anticipate the 90-day cliff by prescriber may become a very effective strategy for leveraging this fact.
In this example, 30% of patients dropped all RA biologic therapy by their third Rx. Another 11% switch biologic brands at least once in the first year, and 6% of those also stopped therapy in that first year. The ability to examine prescribers and index them by their patients’ propensity to stop therapy at certain intervals, and then target more effectively as their patients near the 90-day mark, can provide the brand with a “just-in-time” intervention.
In Figure 2, the data helps us understand who is most likely to switch and why. In this example, nearly 66% of young males discontinue or switch versus only 14% of females. Understanding who these patients are allows you to focus efforts where they are needed most.
Similarly, physicians who switch patients to a different biologic therapy indicate they often do so for efficacy. Understanding why the switch occurs or why the patient stops altogether is critically important to help address the issue. If efficacy is an issue—or a perceived issue on the part of the prescriber—the ability to combat that perception through specific clinical information will be key to reversing the course of the patient’s journey.
With all of the new access to robust data around the patient journey, you can drill deeper and more quickly to reap benefits that help patients and, at the same time, reward your brand.