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Interview

Enhancing Patient Services: Payer and Provider Considerations

Patient services emerged as a central topic at AXS24, with many stakeholders emphasizing the need for consistency and accessibility in patient support. They also highlighted the importance of addressing both financial and emotional support for patients. In this interview, Dee Chaudhary, Principal at Clarivate Commercial Strategy Consulting Group, shared findings from her session at the annual conference.


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Please introduce yourself by stating your name, title, organization, and relevant professional experience.

Dee Chaudhary: My name is Dee Chaudhry, and I'm with the Clarivate Commercial Strategy Consulting Group. I have more than 20 years of experience in pharma, biotech, medtech, and consulting. I am really excited to lead this incredible team that did the research about the topic we're discussing.

They came with substantive work in patient services, the medical field, and analytics. I would say of all the professional background I have, what really made this so interesting was the fact that I had also led patient service teams. So, I came in from the other side with the biopharma background and then to be able to go through and begin discussing it and doing the research was just really impressive and incredible for me.

What were the findings of the 2023 inaugural results regarding the urgent and unmet needs in patient services programs shared at Asembia 2024?

Dee Chaudhary: Last year's inaugural work at Asembia allowed us to look at oncolytics.

We looked at 20 oral oncolytics that were recently launched from small- and mid-sized pharma companies. And the result demonstrated a couple key points: the HCP and the patients are generally satisfied with what we would consider table stakes for patient service programs or hub services. For example, can I get a benefit verification run? Do they have copay assistance? How about the general financial ability? Can my patient get the product in their hand?

[Patients and providers are] happy with that. This research demonstrated that there are opportunities for improvement—something I think is really key when you look at research— and it is possible to provide objective measures for a subject that people really think is more a point of view.

It's a subjective area, meaning, how do you like your patient services? The other thing that we found in this research is that there's truly a need for consistency. And that really came out last year, that whether it is across what you do in different areas of your service or what, as an industry, pharma is providing across their patient service programs. Patients and practitioners want that consistency. And then finally, last year really allowed us to really identify what the key points needed to be when you look at what is necessary for a good patient service program and what those unmet needs could be.

We looked at consumer needs, accessibility, satisfaction, and outreach and broke these down into subcategories and attributes. But the whole point is what is truly needed to allow for adherence, for something to be compliant, and for real access and accessibility to therapy for these patients. So, we started with oncology, and then we moved on.

Can you provide examples of patient access issues? Did the study you conducted last year reveal any details about those issues?

Dee Chaudhary: Some of the access issues that came out is that you would have individuals not even told that there were support programs. They were so dependent on their clinicians.

That's interesting because, in oncology, we often have things like nurse navigators and reimbursement specialists, but the practitioners don't always have the time, and that's where the connection comes. The practitioners don't always have the time, nor do they. Is it top of mind as you're discussing your cancer? There also is a support program. So, somehow, access falls by the wayside. They are expecting other people to be able to do that.

Patients often don't go looking for it on their own. Again, that financial constraint can still be a problem.

When you talk about access, you also consider what other people are doing. That sense of the community's need to feel good about taking the product that access still is part of, and access to patient service programs allows for broader support of that patient rather than just financial. Access in many ways is more than just the finance it's how do I get to my appointment it's how do I get the financial support, but how do I get the emotional support? So, there's a lot that goes into that that can be addressed by a patient support service program.

What are some key findings of the 2024 study from your Asembia session? Did any of those aspects change? Was the feedback any different?

Dee Chaudhary: Again, adherence, being able to assist in a compliant manner, and broader financial assistance still came forward, but there were other aspects. We continue to define these patient needs and the expectations of the HCP for these patient support programs that we found they desired more. What they wanted to see was born out even further in the second area.

In this area, 20 neurology products are available across various disease states. They were newly launched, small, and minimally sized. But what was interesting was that we added more of the patient perspective, and that was able to show, just like you asked here, you know, what was different, and what did they want? And there were several things they wanted.

Through the surveys, the desk research, and live conversations, we found they wanted the ability to see what was out there. They wanted the practitioner to tell them where to go but they weren't getting that.

The data shows the average practitioner spends about a minute talking with the patient about any non-disease state area. But the provider doesn't have the time and is out the door. So, we found that these typical provider services—not unchanged from last year—about 50% of the groups where we reviewed their services a score of 6 out of 7. They're doing well again on that financial end. 

Forty percent of the HCPs said that there was a real ease of use, and that the technology could be better, but that it assisted them. There were some areas that just continued to be a surprise. That ease-of-use aspect, which was so surprising if you look at a neurology population, only one of the 20 received a score of a 6 out of 7.

Now, you have individuals that were compromised; they have a disability, they maybe can't move their hands, they're having difficulty speaking, they're having difficulty writing. We still have places that we're requesting wet signatures on forms for people that maybe can't move any longer. There were so many things that were more evident, I think, in this neurology population, but that doesn't mean that it's not evident across every therapeutic area.

The other thing that we really focused on that was unique here and I think speaks a lot to seeing the patient where they're at is the use of social media. We specifically called out in this study. We found only 20% of these survey patient support programs had anything on the app store. The use of YouTube where most of the patients go was very, very low, which is interesting because YouTube could drive patients back to these support services. It would allow them to put compliant messages that are already on their website that the patient doesn't know about. They all focused in on LinkedIn, which is a professional environment, not a patient environment.

They would do a lot on Facebook as well. Facebook is a place to start building community, but it's not a place to get information. [Patients] will go back to YouTube for the data they need.

They'll connect with like patients, etc, and get some direction, but to put your patient support on Facebook and expect that will drive the patient to where they need to be and that that will fill the patient's need is really not the case. So, all of that data bore out the fact that while they're looking to assist in these programs with adherence in a compliant fashion and provide that assistance, they're not getting to the patient where they are, nor are they giving the patient all of those other aspects to the to the degree that could be able to the manner that is possible, but we did see some super positive results that if each could borrow from one another, I have to say, we would have the perfect patient support program.

Given the recent statistics from the AMA indicating a significant drop in the number of people enrolling to become physicians by 2036, what do you think will happen to patient care and access to medical services in the future, especially considering that doctors currently spend very little time discussing access with their patients?

Dee Chaudhary: You know as thin as we currently are, we [also] have a nursing shortage on top of it. We must realize now we have clinicians and physicians being stretched because they don't have the nursing support they need.

Then, we need the reimbursement coordinators who used to be there. What will happen is that there will need to be something that can fill the gap. That is where patient support services can partner with payers and the HCPs to provide that guidance, good disease state information, and good data on advocacy programs nearby and open clinical trials. How about other support groups and people like them or provide them with mentors? Do what the payers, providers, and their staff want to do. Still, they may be unable to stay closely aligned and in touch with the patient just because of all their responsibilities, including metrics and all of these other aspects that have now been put on their plate.

Some people want to do the right thing, whether they're with industry, whether they're with the providers, or whether they're payers. They have to come together and find a way to do it to overcome just what you talked about. And the thing is, you know, we're in this era of value-based care, where an AI, where everyone's trying to focus on reducing the burden on the physician and the provider, because not only are they treating patients, they're doing administrative work and patient services to me seems like a separate entity. Well, and this is strictly an opinion, obviously doesn't mean it's true, but when I think about patient services versus what I get from my provider, I do want my provider to make me aware of like what's going on, but a dedicated entity like a patient services program, I would feel more comfortable because that is the only thing that they're focusing on. In contrast, a provider is focusing on treatment and finishing other duties.

Do you think a well-established patient services program can allow providers to spend more time focusing on patient care instead of being burdened with other responsibilities?

Dee Chaudhary: If they can become a trusted partner, it takes a lot, and that takes bringing good resources from key opinion leaders. That requires having data that is supported so that you're not putting out something that looks so incredibly promotional that the provider may be uncomfortable with sending someone there. It is providing or offering the provider; how can I appeal this? Do you have letters of appeal? Do you have letters of medical necessity? But be there when they need you, be there professionally, and show the singular dedication to the patient that the provider has.

I've seen some patient service programs go in, and it feels as if we're doing this for our own standards and what's best for us rather than what's best for the provider and patient. They're not doing it wrong. They just don't know another way to present it.

And that doesn't resonate very well with the provider. We have found that it is more convenient for you to fill out these forms by hand or fax them in because those things make it difficult to be a trusted partner. That's just one of the areas that if you can begin to be, again, where the patient is and where the provider is and do it with the patient in mind, these programs will become even more successful than they currently are.

Which patient services programs did you highlight at Asembia that you envision could serve as templates for other programs?

Dee Chaudhary: Some things came to mind. One of the programs had these templates, and I'm reluctant to call out the specific programs just because it becomes, why did I talk about one and not the other? But within that neurology space, that data is available at Asembia, which companies they were.

One of the companies put together very systematic clinical data sets that could be used within EHR. This allowed the physician to make it easier to order the product. They were able to work on putting together very systematic responses to what to do if we need to run an appeal. The physicians don't have that. Those were incredible opportunities to help, again, to help the patient get the drug. Another company worked specifically in the area of RETS; they supported the families.

This is a disease where a genetic disease where children are affected badly with a neurologic impairment. And they had support for the families. They had something for the siblings: a scholarship for the siblings.

It recognized that this was a family disease and had another program that worked specifically on helping people understand what genetic testing was and let them look in. These weren't necessary for the product per se, but they were so good for the patient. They even had a mentor program. Those things bring somebody hand in hand through what you're dealing with. For example, if I'm in a wheelchair and struggle to get around, but I have somebody there who can talk about how they made it through that. Those who can talk about that? I just came out so inspired by these together and then heard what it meant to them from the patients. It was a positive experience.

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