By: Erica Conroy, Ph.D., Vice President of Specialty, CoverMyMeds & Heather Morel,Ph.D., MBA, Senior Vice President and General Manager, Access and Adherence, RxCrossroads by McKesson
Many current biomedical innovations moving from bench to bedside are considered specialty therapeutics. In fact, it’s estimated that 65% of newly launched medicines within the next four years will be specialty – that’s about 35 each year.1 Such therapies give hope to many patients struggling with chronic and orphan diseases like cancer, heart disease, multiple sclerosis (MS), autoimmune conditions and viral infections like hepatitis C and HIV/AIDS.
Despite potential health benefits, the cost and complexity of specialty medications can create distinct challenges for patients. Barriers of access, affordability and adherence can keep them from the medications they need to be well. Learn more about these challenges and considerations for MS patients prescribed specialty medications in CoverMyMeds’ recent white paper.
Manufacturer-sponsored drug access and support services, often called “hub programs,” aim to help patients overcome such obstacles. Fulfilling insurance requirements, coordinating financial assistance and helping patients remain on therapy are common offerings among many hub service providers.
The problem is, so many patients aren’t aware of this helping hand. In a survey to 10,000 patients, it was discovered that only one of five had even heard of support services.3 Manual processes and poor communication among health care stakeholders can also reduce the effectiveness of these programs.
When patients are effectively supported, the difference is clear: streamlined access, affordability options and adherence assistance can improve patient outcomes. A study involving nearly 6,000 patients found that when complex medications for cancer, MS and autoimmune conditions were accompanied with support services, the odds of patients remaining adherent were on average 23% higher (and in some cases 39% higher) than without such support.2
AMP: Access for More PatientsTM, a new technology-driven solution from CoverMyMeds and RxCrossroads by McKesson, enables effective patient support for specialty medications by leveraging network connections and creating efficiencies within provider workflows.
Through CoverMyMeds’ extensive network of more than 700,000 providers, payers representing 96% of prescription volume, 96% of pharmacies and over 200 life science brands, we have set a new starting point for patient access and support for specialty therapies with a proprietary, end-to-end solution. Along with RxCrossroads’ 20+ years of deep expertise providing high-touch human support for patients prescribed complex specialty drug regimens, this solution fundamentally changes the way patient support is provided.
By moving enrollment into access and support services upstream at the point of prescribing, we are “bringing the hub” to CoverMyMeds’ network to accelerate provider adoption so that all patients can be supported along their journeys. This solution is connected with over 500 EHR systems so that when an e-prescription is written, patient enrollment can seamlessly begin in the same CoverMyMeds portal that providers often use for electronic prior authorization support. As providers remain patients’ most trusted source of health care information, CoverMyMeds’ provider network is the missing link that can be leveraged to seamlessly connect patients with support services.4
Within the last 90 days, approximately two-thirds of specialty providers from major therapeutic areas including neurology, oncology, rheumatology and gastroenterology have accessed and used the CoverMyMeds portal.5 In fact, for certain centers of excellence in neurology, utilization of the CoverMyMeds portal has reached 94% of specialty providers.6 From this central location, providers can easily complete patient enrollment and start patients on therapy within their existing workflows.
Comprehensive Patient Support Powered by Technology
In contrast to traditional hub programs, AMP provides a streamlined electronic experience throughout the access process. Stakeholders have clear visibility into which steps need to be completed and who is responsible for them within the specialty dashboard. Through such network connectivity, AMP can increase workflow visibility and transparency among members of the patient care team while allowing for real-time transfer of pertinent information – accelerating historically slow, time-consuming processes. In fact, data from a recent two-month pilot study of a neurology medication for a narrow patient population shows patient’s enrolled in AMP experienced a 27% reduction in time-to-therapy relative to the industry standard.
Enrollment steps like lab scheduling, prescription titration, benefits verification/investigation, prior authorization, financial assistance and selecting an appropriate specialty pharmacy for medication dispense are all completed within the platform, saving administrative time and cost. The pilot study found that reimbursement-related steps were completed in 11 days on average, compared to the weeks they can take through a traditional, manual hub program.
Throughout the process, human intervention is available to assist with patient access at any point. Expert case managers and support specialists from CoverMyMeds and RxCrossroads deliver timely resolution support for any complications, as well as targeted adherence support for patients.
Discover more about how CoverMyMeds and RxCrossroads by McKesson are helping patients get the specialty medications they need at go.covermymeds.com/amp.
- The Global Use of Medicine in 2019 and Outlook to 2023, IQVIA Institute for Human Data Science
- A Comparison of Pharmacy Dispensing Channel Use and Adherence to Specialty Drugs Among Medicare Part D Beneficiaries, 2018
- Patient Services – Pharma’s Best Kept Secret, Accenture Life Sciences, 2015
- The Patient Is IN – Pharma’s Growing Opportunity in Patient Services, Accenture Life Sciences, 2016
- CoverMyMeds data on file, 2019
- CoverMyMeds data on file, 2019