The State of Patient Support Services in Today’s Landscape

Gajanan Kulkarni

The fundamental goal of patient support programs—whether it’s a hub, patient assistance program (PAP), or adherence support services—is to expedite patient access to therapy. However, the reality of that goal sometimes falls short of expectations due to linear and rigid pathways, which can cause significant medication access delays. On average, some outdated patient support models can postpone treatment by up to eight weeks¹—a reality that’s unacceptable, especially for patients facing potentially life-threatening conditions.

When patient support services are enhanced with innovative technology, it simplifies the process for pharmaceutical companies, providers, pharmacists, and payers to connect patients and their caregivers with essential support. It also helps provider teams move beyond outdated processes and enrollment systems.

In today’s landscape, effective patient support services require a hybrid approach that merges advanced technology with human connection. This combination is crucial in delivering impactful patient care.

To navigate these complexities and enhance the therapy lifecycle management for patients, having a strategic partner is essential. This partner should act as a bridge, possessing deep knowledge, experience, and an extensive network to help craft better patient journeys. They should offer a tailored approach through a comprehensive suite of solutions that go beyond basic access services to address specific challenges and meet the unique needs of all industry players and patients.

Assessing the barriers to successful patient services

To effectively enhance patient support services, it’s important to first understand the barriers care teams and industry partners face.

Providers and their clinical staff often encounter several obstacles that can impede the delivery of efficient patient care. According to the 2022 CoverMyMeds Medication Access Report, a staggering 95% of providers prescribing specialty medications encountered difficulties initiating therapy for their patients.² These challenges often stem from outdated technology, such as reliance on phones, faxes, and multiple logins, which complicate the navigation of patient support services and lead to inefficiencies and staff burnout. In addition to this, other challenges include:

• Fragmented, dated workflows: Outdated hub models slow down the therapy initiation process, which is critical for patients needing immediate access to medications.
• Fractured patient enrollment paths: Complex and disjointed enrollment processes add unnecessary time, effort, and stress, further overwhelming care teams and delaying patient care.
• Inflexible support programs: Generic, “one-size-fits-all” solutions that do not meet the specific needs of diverse patient groups, leading to suboptimal support and overall care.

Patients also feel the impact of these inefficiencies. The same report highlighted that 20% of specialty patients are more likely to forgo filling their prescriptions now compared to a decade ago, primarily due to high costs and accessibility issues.² This trend toward increased medication abandonment and non-adherence is alarming and calls for a transformation in how support services are delivered.

For pharmaceutical partners, the fragmentation across systems presents significant barriers and limits patient access to their innovative therapies.

The complexity of these challenges across different stakeholders underscores the need for a tailored approach rather than a blanketed solution. It requires a consultative, hybrid strategy that combines tech-enabled solutions and an experienced team of experts. By leveraging new technologies, expanding network connections, and utilizing clinical expertise, barriers to timely medication access can be removed, which significantly improve outcomes for patients.

Leveraging advanced technology and human care

Integrated solutions can begin to enhance patient support services—now and in the future—in order to expedite medication access for patients. This can be achieved by:

• Simplifying provider workflows through a single-entry point: Clinical care teams should be able to access services through a singular point of entry that’s integrated into their existing workflows. This will help enable a more simplified user experience to help patients get the medicine they need without exhausting resources or staff. Fully integrated solutions increase transparency, reduce redundancy, and improve functionality for providers and their care teams, maximizing the benefits delivered to patients in the end.
• Facilitating connections to payers and manual support from experts: To confirm patients’ benefit coverage, lean into a partner with payer relationships so that patients can access therapies regardless of benefit type. This helps mitigate dependencies on predictive results with a singular source of updated information.
• Leaning into the importance of human connections: When care teams effectively utilize integrated tech-enabled hubs alongside human services, they can significantly improve their effectiveness. Adding human-driven wrap-around services to patient support programs addresses many needs, including field reimbursement support, copay programs, non-commercial dispensing, healthcare provider education, and clinical and behavioral adherence support. These comprehensive solutions not only address immediate needs but also help sustain patient engagement and compliance. Taking it a step further, human connection can play a pivotal role in addressing the social determinants of health. By fostering strong relationships and supportive networks, we can help break down barriers that often prevent individuals from accessing healthcare. This approach not only enhances patient well-being but also contributes to healthier, more resilient communities.

The key to patient support success relies on a tailored approach that addresses the unique and often non-linear paths patients take to access their needed therapy. Moreover, when solutions are integrated with advanced technology and high-touch human interactions, care teams can deliver a smoother patient experience. This dynamic combination of technology and personalized human service is essential for adapting to the ever-changing landscape of healthcare.

About the Author

Gajanan Kulkarni is the VP of product management at CoverMyMeds, bringing over 25 years of experience in consulting and product leadership roles in the healthcare industry. He is responsible for overseeing CoverMyMeds' Patient Support Services portfolio, which includes hub and field reimbursement services, patient assistance programs and clinical and behavioral adherence services. In this role, Kulkarni aims to understand the complexity of the patient journey in relation to specialty medicines, recognizing the challenges and intricacies involved at every stage.

References

1. CoverMyMeds data on file, 2023.

2. CoverMyMeds Medication Access Report. 2022. https://insights.covermymeds.com/medication-access-report.