Trade & Channel Strategies 2024: The Role of Patient Service Teams in Driving Direct-to-Patient Adherence

PC: What roles do patient services teams play in driving adherence within the direct-to-patient model, and what tools have been most effective?

O’Meara: A patient service team can help from the initial script coming in through ongoing adherence and persistency initiatives. We’re going to help them understand where they from a reimbursement perspective are and keep them aware of the status. There’s a prior authorization required to help them with copay, enrollment, and affordability. They can also get help from us and other partners in the ecosystem from clinical education, ongoing medical information and support, and refill reminders.

PC: Can you share examples of how Direct-to-Patient initiatives have accelerated time to market for new therapies?

O’Meara: It’s not only time to market, but also faster time to therapy for a patient. It used to be, you write a prescription, maybe it goes off, maybe the pharmacy has it in stock, maybe they don’t. They might have a different product in stock, maybe they support the prior authorization. DTP can really help when that script comes in. This way, resources are in place to help a physician go through the reimbursement process and can get the product back to a patient as quick as a day. Maybe from a launch perspective, DTP can be driving awareness and help patients with self-assessment tools so they can understand what's happening. What are some of the options? It might be a physician finder or a telehealth provider, helping them get that initial access to therapy.

Full Interview Summary: The "Patient-Centered 3.0: How Direct to Patient is the New Commercialization Model" panel explored the evolving landscape of direct-to-patient (DTP) models in pharmaceutical commercialization. This approach emphasizes empowering patients to understand their disease states, raising awareness, facilitating access to therapy, and ensuring adherence. The panel discussed the complexity of navigating today’s healthcare ecosystem and how DTP models address these challenges.

Key obstacles identified include payer contracts, reimbursement hurdles, and prescribing difficulties faced by physicians. These factors collectively complicate patient access to therapies. DTP models aim to simplify the process by offering greater transparency around pricing and coverage, expediting access to medications, and supporting patients throughout their treatment journey. This support extends from initial prescription authorization to affordability assistance and refill reminders, ensuring patients remain adherent to prescribed therapies.

Patient service teams were highlighted as pivotal in improving adherence through education, ongoing support, and affordability programs. These teams help patients navigate insurance processes, manage prior authorizations, enroll in copay assistance, and access clinical resources. Effective tools include self-assessment platforms, telehealth services, and physician locators, which streamline access to care and reduce time to therapy.

DTP initiatives have also accelerated the speed of therapy delivery. By enabling real-time coordination between prescribers and payers, patients can receive medications in as little as one day. The panel noted that DTP approaches drive awareness during product launches, enhance patient engagement, and foster a more efficient healthcare ecosystem.

Looking ahead, the next evolution of patient-centric models will focus on simplifying the increasingly complex healthcare environment. Innovations could include payer reforms, improved pricing structures, and enhanced pathways to ensure faster, more affordable access to therapies while prioritizing patient outcomes. The ultimate goal remains a seamless, patient-focused experience that delivers optimal care at reduced complexity.