Pharmaceutical Patient Support & Access: 6 Trends to Watch
Key takeaways from the 2019 World Congress Integrate meeting
Archbow team members Douglas Bock, Kevin Cast, Paul Furgal, and Melissa Waetjen joined colleagues from around the industry at the World Congress Integrate meeting in Philadelphia, PA in late July. The focus of the meeting was to share best practices for improving support and access from manufacturers to patients, providers, and networks.
The presentations and panel discussions were engaging, and the meeting as a whole provided a great opportunity to discuss key issues facing the industry. Six essential topics stood out as key takeaways from the meeting:
Don’t underestimate the importance of IDNs. IDNs continue to get better organized and more committed to the Specialty Pharmacy space. They make a compelling, passionate argument that they should have access to limited distribution drugs, despite recognized deficiencies such as PBM network exclusion, inferior data outputs, and IDN market fragmentation. As IDNs continue to address these deficiencies and increase their “ownership” of the patient, their significance to manufacturers will continue to grow.
“Ownership” of the patient increases stakeholder value. An essential area where IDNs can prove their permanence will be in long-term management of patients. IDNs need to show manufacturers and payers that they can manage the patient better than stand-alone or payer-owned Specialty Pharmacies. Because they are essentially in the business of population health management, and they have deep connectivity to HCPs, they should, in theory, have the ability to manage the patient comprehensively. However, consistent success (and defining success) of comprehensive health management is still elusive.
There’s no one formula for contracting with Specialty Pharmacies. One could argue that there never was, but today’s SP contracting includes more novel approaches than ever. Manufacturers can enhance their arrangements with SP partners by including:
Operational FTEs that focus solely on one program
Compensation for superior adherence and turn-around times
Clinical trial patient identification
Restrictions on selling/reporting data to third-party aggregators like IQVIA
Leveraging 340B as a mechanism to maximize product penetration
Working with PSAOs and other consolidators for “tweener” product support
Kevin Cast led a panel discussion on the best Specialty Pharmacy contracting practices for reimbursement and access with members of the AstraZeneca team.
Compliance when working with 501c3s should be proactive rather than reactive. The benefits of working with a 501c3 organization typically outweigh the risks, but that doesn’t mean manufacturer compliance teams can rest easy. As a rule of thumb, the government often will assume ill-intent when manufacturers donate to 501c3s. Documenting donation decisions contemporaneously is vital, and much more powerful than having defense attorneys spin a story if the DOJ launches an investigation. Patient access and compliance teams should be active partners in all 501c3 activity.
Behind every patient is a human. The conversation around patient-centricity continues to evolve and has now expanded into the idea of bringing humanity into the healthcare space. It’s important to remember that for patients (who prefer to be referred to as “people who have a condition”), success is not about taking pills. It’s about living a life that is productive and symptom-free; it’s about wellness. Manufacturers can do a better job of understanding the customer’s whole story – what it’s like to live with a condition 24 hours/day, 365 days/year. Good things come to those who engage patients early in the journey, and as John Liddell, panelist and person with COPD, noted, “if [the conversation happens] without us, it’s not about us.”
Value-based contracting (VBC) isn’t going away…it also hasn’t been totally figured out yet. We’ve all been talking about VBC for a while now, and yet we still have more questions than answers. Can we all agree on a clear definition of VBC? What outcomes should be evaluated? Who holds the risk? If a cost cap is ever implemented, there could be severe best price implications when/if the cap runs over and pharma has to pay a rebate back to the payer or assume the expense. Either option could be seen as a discount and impact best price. The conversation on VBC will continue until policy changes that contemplate today’s product mix are introduced.
At Archbow, our team is actively committed to staying engaged in the evolving pharmaceutical marketplace so we can provide our clients with the most strategic, up-to-date perspectives and guidance. Contact us today to learn more about how we can assist with your next commercialization project.
Archbow Consulting helps pharmaceutical and biotech companies in the USA and Europe design, build, and optimize product distribution and patient access strategies. Archbow was founded by industry veterans to meet a need in the marketplace for consulting options that offer diverse real-world experience, are able to leverage deep connections across the industry, and can also provide actionable strategic guidance. We invite you to learn more about our team, services, and clients’ success, and connect with us via email, LinkedIn, Twitter or subscribing to this blog which you can do below.