5% were hospitalized during the period they were awaiting their drugs<\/li>\n<\/ul>\nThe study highlights how roadblocks in the provider environment can negatively impact outcomes\u2014underlining the importance of payer strategies that address access barriers beyond coverage. How do you do it? Here are some essential steps.<\/p>\n
1. Collaborate<\/h3>\n
Developing a holistic strategy isn\u2019t just down to the payer team\u2014it\u2019s a collaborative exercise. It\u2019s important to establish a multidisciplinary team (MDT) that captures perspectives from across the business, including brand, policy, advocacy, medical, and legal. These insights, along with input from external partners, are key to designing agile access strategies and customer-centered solutions. The MDT should be established early and engaged throughout the brand lifecycle.<\/p>\n
2. Define All Elements of Access<\/h3>\n
Start by defining what access actually means for your specific therapy. This will vary depending on labelling and requirements. Once you\u2019ve defined access, examine existing pathways to identify potential barriers. This will provide the baseline for your market access strategy.<\/p>\n
The trick is to identify the critical success factors for access. These will guide solutions that ensure your therapy is readily accessible to patients, wherever they are. For example, for a physician-administered infusion drug in oncology, access means ensuring your therapy is available at both provider offices and hospital infusion suites\u2014and that, no matter what, payers will support coverage and reimbursement in both settings.<\/p>\n
3. Hit the Ground Running<\/h3>\n
Interim solutions that help physicians initiate therapies quickly are an important consideration. As the\u00a0monoclonal therapy example shows, delays in filling prescriptions have real-world consequences. Interim solutions can help accelerate access when a therapy is first available. This is crucial. If providers and patients have difficulty accessing it early in the process, customer confidence can quickly erode and have a lasting customer experience. It\u2019s difficult to bounce back.<\/p>\n
4. Focus on Customer Experience<\/h3>\n
From a provider perspective, when it comes to prescribing and\/or procuring a therapy, convenience is king. It\u2019s important to understand customer needs from a business perspective taking into account geographic factors. For instance, some hospitals may not be able to proactively keep stock of costly specialty drugs. An effective payer strategy will identify this early and develop solutions to combat it. For example, consignment programs may\u00a0help make drugs available to providers without the financial risk. Tailored payer marketing that educates providers on the options and reimbursement codes open to them is essential.<\/p>\n
5. Think Beyond the Commercial Patient<\/h3>\n
Affordability and treatment compliance is everything. However, payer strategies must consider more on long-term outcomes. If the patient can\u2019t be on a treatment long term, we won\u2019t see the long-term clinical\u00a0benefits. More often than not, the patients who could benefit most from a drug in the U.S. are Medicare, Medicaid, or even federal\/government patients who can\u2019t take advantage of copay cards. The value of a drug can only be realized if companies provide education and tools that encourage payers to make it available to all appropriate patients at the right time and place and for the complete duration of the treatment. The best tools will help them measure outcomes\u2014whether that\u2019s a clinical outcome or a healthcare quality score.<\/p>\n
Ultimately, if a drug isn\u2019t accessible, there is no value. Pharma companies therefore need to develop non-traditional solutions that overcome complex access barriers from the point of view of the ultimate customers (providers and patients) not just the payers. The best solutions won\u2019t just focus on payer-centric issues, they\u2019ll make the whole patient experience\u2014and the provider roadblocks to it\u2014their top priority.<\/p>\n","protected":false},"excerpt":{"rendered":"
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