Advocacy and support programs for patients are among the most important aspects of the health care equation, but are often overlooked or under-utilized. Here’s how pharmaceutical brand teams can be a vital player in the process.

It is a scenario that is likely being played out every hour of every day in a country where about 50 million people are without health insurance. An uninsured patient, who can’t afford to visit a doctor, waits until he is in severe pain before he finally goes to the emergency room. He is diagnosed with a disease for which the only treatment on the market has proven to be extremely effective but is quite expensive to pay for out of pocket. The patient may be seen in an institution where pharmaceutical representatives are prohibited and can’t provide Branded information about the drug. So the HCPs in the office are unaware of the services provided by the Brand. Choosing to use his limited resources on his family instead of himself, the patient dies from the untreated disease. In a situation such as this, a patient advocate may have been able to save the day.

WHAT IS A PATIENT ADVOCATE?

There are many forms of patient advocacy and many ways to interpret just who or what makes a “patient advocate.” They can be found in all settings although they are often overlooked. Finding the best way to communicate with various types of advocates can be the tricky part. A patient advocate may be:

  • Your pharmacist, who ensures you are receiving the correct therapies, for the correct reasons, at the correct times.
  • Your social worker, who assists you in gaining access to therapies, appointments or support.
  • A close friend, who comes to visit and ensures you have food in your house, checks to makes sure you have plenty of medication in your prescription bottles, or just to keep you company.
  • A pharmaceutical Brand team which offers patient support and assistance.

HOW CAN BRAND TEAMS PROVIDE SUPPORT?

The goal of patient support programs is to assist patients as they transition to a new treatment, establish meaningful communication with patients to help make their lives easier, and serve as an extension of the Brand team with both Health Care Professionals and patients. But no matter how prepared one is, under the stress of any diagnosis people are likely to overlook some questions. Through their one-on-one relationship, Branded Case Managers are capable of providing 24/7- access to information and support, offering a wealth of knowledge to key decision makers who would not normally be aware of the available support options.

Services that patient support programs can provide include appointment reminders, as well as medication adherence reminders and assessment. Adherence can be measured through verbal assessment or by medication management devices that provide reliable tracking of medication adherence and data for reportable results. The goal of Case Managers is to increase education surrounding the medication, associated disease states, and available services, which in turn increases Patients/Caregivers/Advocates access to medication. Such education communicates the risks and benefits associated with treatment and empowers patients to question their providers regarding their therapy, while providing guidance on what to expect from treatment.

Most, if not all, Brands have a hotline for general information. These hotlines are typically Branded or Unbranded and are usually in direct response to advertising. Their strategy may include screening and assessing callers and providing information of the benefits of enrolling into a program. If staffed with registered nurses, they may provide information on the disease state, treatment options, and how to be better prepared to deal with the diagnosis. The program may even assign a personal Case Manager who would be available to patients and caregivers to answer any questions, provide support, and review informational materials, empowering the patient/caregiver with confidence in their treatment—(usually Branded).

BRANDED PATIENT ADVOCACY STRATEGY

In one support program, calls are scheduled to review supplied care kits, answer any questions, prepare patients for what to expect with treatment, and provide emotional support. The inbound component is a 24/7, 365-day patient support line. Patients can call at any time to sign up for services, have questions answered and communicate concerns. This inbound line is a source of significant lead generation for the second piece of the program, which is responsible for management of the relationship.

The case management program assigns a single Case Manager to a patient to provide support via strategically timed outbound touches. The Case Manager serves as a resource to the patient, committed to assisting and supporting the patient through the entire lifecycle of the disease state. Once the patient has entered the relationship management program, the Case Managers further develop the relationship. They provide information regarding what to expect during treatment, how the drug works, how to receive copay assistance, review fulfillment pieces, etc.

Nurses or Case Managers provide their patients with information in the decision-making process, support the patients through drug initiation, and continue the relationship while their patient stays on the drug. The patient receives both direct mail and outbound calls on a semi-regular schedule, which allows the program to assist patients in choosing the drug, as well as keeping them on it. Nurses or Case Managers are provided with continuing education and training throughout the life of the program.

Applying this strategy to a costly Branded product achieved great results. By modeling a program after the key points above, the caller enrollment conversion into the case management program increased from 4-to-30 % in the first four months and has remained steady ever since. After being enrolled in the service, 886 patients requested the treatment (by name) to their prescriber and 639 of those patients were granted the treatment.

HOW DO BRAND TEAMS RAISE AWARENESS?

The prescriber is not the only one making the decision for treatment anymore. Patients/Caregivers/Advocates are empowered to research and discuss options with their doctors. But how is awareness raised among the general public regarding available services? Determining and targeting the key decision makers is paramount in raising awareness of these programs.

Much of the product information provided by Brand Teams is a low priority until the physicians and other HCPs have a patient they need to treat or manage.

Often, the information provided by Brand Teams is not fully absorbed and key information on topics such as patient support programs is lost or forgotten. At the point of treatment, HCPs do not always have program materials, such as enrollment forms, readily available.

In other instances, it is difficult for sales reps to access institutions, limiting the amount of education the staff members receive regarding services associated with a particular Brand. In these instances, it’s necessary to raise awareness of Branded programs through non-conventional methods to ensure the information gets to the patients. This helps to improve the patient experience and outcomes by ensuring the relevant HCPs have a full understanding of the support programs and can leverage them to their full extent to benefit the patient.

OUTREACH PROGRAM OBJECTIVES

In an age of increasing technology and decreasing access to advocates—social workers, nurses, prescribers, pharmacists, etc.—it is imperative to employ new methods of contact. The objective for an outreach program should be to improve delivery of timely information to Health Care Professionals in order to increase their understanding of Brand Services, while increasing the frequency of Brand contact with these key people.

The strategy behind a program would support the sales force through communications to and with HCPs and their offices. Introductory calls may be placed to introduce services provided such as patient support programs, a 30-day free trial, etc. However, these representatives should also be able to provide call summaries and fulfillment requests to communicate with field sales representatives.

When this strategy was applied to the services available for a Branded product, the tele-sales team reached 55% of the right party contacts in the first four months of the program. Of the contacts made, 580 offices requested and received information. As these calls can be placed whenever is most convenient for the offices, and typically do not take up a whole lot of time, there are low opt-out rates; for this program it was only 2%.

The team, specifically the agents, regularly receives positive feedback from patients, caregivers and field sales representatives. In one recent example, a sales specialist wrote to express his gratitude for his associated telesales representative, noting that she is always available and willing to help. In addition to her accessibility, she was able to leverage her experience to grant him access to an office that would typically not allow field sales representatives into the facility. She was able to effectively and efficiently communicate to the office team the benefit of the programs associated with the product and just how helpful the information would be for their next patient. In essence, it was a win-win for everybody.

  • Dr. Moriah Weissman, who is a Certified Consultant Pharmacist (CCP) and a Guest Lecturer at the Philadelphia College of Pharmacy and for Comprehensive Continuing Education, LLC, serves as a Clinical Director with Tunstall AMAC working with life science companies to provide clinical insights for the development of patient, caregiver, and healthcare provider support and communication programs. In this role, Dr. Weissman oversees the clinical staff working at Tunstall AMAC and has been responsible for developing a Certificate of Excellence Program to provide on-going clinical development for all staff. Dr. Weissman is also founder and co-owner of a medication management company through which she volunteers in the New York and New Jersey areas providing medication education and helping patients manage their medication regimens.

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