Improving Outcomes With Patient Support Services
An Interview with Arpan Patel, RPh, MBA, SVP Trade, Technology, & Patient Access at Asembia
Are HUB and patient support services important for managing use of specialty pharmaceuticals? How so?
A well-designed HUB service model can positively impact specialty pharmacy patient experiences and outcomes, as well as benefit manufacturers of complex specialty medications. I work with my clients to make a product-specific choice based on three key considerations: clinical aspects, payer requirements, and brand needs.
From a clinical perspective, does the therapy need additional support processes that may not be available at pharmacies? The HUB service model provides clinical expertise and advanced training around the specific specialty products. Often, specialty or rare diseases require an additional layer of clinical support services due to the importance of patient adherence, disease state monitoring, patient access, and clinical counseling. Barriers to entry, cost, or access to the product significantly impact clinical outcomes and a HUB service model with available clinicians can address specific patient concerns and enforce medication adherence. In a specialty pharmacy setting, patient counseling opportunities, such as one-on-one counseling, may be limited due to time constraints, alternate patients, and staffing. HUB services remove these outside factors with targeted interventions, specific to the product, that have a holistic impact on the patient’s well-being. In addition, a support service model can generate valuable clinical and status-level data (such as missed dosing, adverse events, and clinical efficacy) with customized clinical content and call scripting for outreach to clinicians and patients. This data, in turn, can be leveraged to improve the patient experience and focus on targeted clinical interventions to improve patient outcomes. 
From a brand perspective, what services could be included to differentiate your brand? As a clinical example, this may be the first product offered to a targeted group of physician who may need additional hand holding. Let’s say a new diabetes drug was coming to market—a high dollar injectable product that will not be stocked at retail. Most prescribers in this class are unfamiliar with specialty pharmacy processes. In this example, the best outcomes may be achieved with patient support services not only for patients, but also for prescribers and their staff. From a brand perspective you may want to offer special services to these patients as well, perhaps compliance calls, support with benefit verification, in-house nurse visits. Overall a center of excellence that puts your product first, vs a pharmacy where your product is one of many products supported.
From the payer side, consider what steps will be needed to get coverage for this product? Will the product have formulary coverage? How many prior authorizations are anticipated? For second or third to market products, are there step therapy requirements to consider? Services may be essential to help overcome barriers, such as information and assistance for prescribers and their staff to gather information to complete prior authorizations and appeals. In some cases, the product may merit field level PA support as well.
How are Asembia’s HUB and patient support services unique?
Asembia offers a unique market position, bringing together best-in-class technology, clinical expertise, and our customizable specialty pharmacy network. Our HUB and patient support services are led by pharmacist with real-life specialty pharmacy experience. Asembia pharmacists serve as product leaders, managing teams of patient care coordinators with pharmacy technician backgrounds. Our expert staff is paired with our own specialty pharmacy software platform, designed specifically to manage patient benefits, specific disease protocols, and integrations with our pharmacy partners. Along with our HUB services, Asembia can offer targeted access through pharmacies in our network. For each program, specific pharmacies are selected, based on expertise and capability.
Can you give an anecdotal example of a case where Asembia was able to use its different capabilities to meet a unique specialty patient need?
Asembia currently manages a comprehensive patient support program that addresses the unique needs of patients with a potentially life-threatening condition. When launching this specialty medication, the manufacturer required our HUB to meet specific patient contact and time-to-fill service requirements (2-hour patient outreach and 48- hour delivery). Following launch, projected referral volume (200 referrals per day) soared beyond expectations (to 1300 referrals/day). This impacted all processes and the original FTE model. Asembia’s clinical program staff quickly developed a unique process to accommodate program requirements and manage high volume cycles within 2 shifts. Asembia also rapidly increased program staff, realigned resources and opened a new office location to expand capacity and time zone coverage. 
New volume projections for a seasonal spike anticipated referral volume would increase again to 3000/day. Asembia quickly identified that adding manpower alone (including all Asembia patient support center locations and outsourcing capacities) still left risk during the projected peak. The Asembia-1 technology team created automated solutions. For example, by aggregating multiple data sources, Asembia developed electronic benefits investigation technology that reduces processing time from days to minutes.
The nonstandard workflow and expedited timeline for this program required customized reporting, including time to fill as well as detailed referral status data encompassing all workflow sub-statuses. Asembia’s technology team tailored Asembia-1 dashboards to collect all required data and quality reporting.
Can you explain how Asembia-1 works? What kind of benefits are gleaned from use of the platform?
Unfortunately, most patient or customer management software is not designed around the patient. Most companies have to modify a generic platform for HUB or pharmacy use to try to accomplish what is required to manage patients. Asembia-1 was developed specifically to fill this gap and enable our customers to effectively manage patients undergoing high-touch specialty therapies. Asembia’s technology solution mimics specialty pharmacy workflow to streamline overall patient management, including processing prior authorization, documenting initial and follow-up patient counseling, capturing data for manufacturer reporting, and tracking adverse events. The web-based platform integrates with pharmacy dispensing systems used by specialty pharmacies across the country.
Can better patient access—gained through the use of this technology—improve adherence and outcomes?
The Asembia-1 platform includes capabilities to capture adherence risk and potentially improve outcomes by providing the user with the information and tools to identify which patients require supplemental adherence counseling and follow-up. Within Asembia-1, the Clinical Consult module houses disease- and drug-specific call scripts and guided data capture that can be utilized to document counseling and patient progress.
Is there anything else you would like to add about Asembia’s services?
Our employee base resides in close proximity to both of our current locations. All patient care coordinators have prior experience and are recruited from regional pharmacies, as well as prescriber offices. Primarily, they are pharmacy technicians. When the program requires, we also recruit pharmacists and nurses as needed. When additional personnel are required, our New Jersey location utilizes the Fairleigh Dickinson School of Pharmacy, which is located within the same corporate campus.
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