Patient Services Are Simplifying the Healthcare Consumer Experience

Kathi Henson

Driven by market dynamics and consumer demand, patient services is a growing business segment for life sciences companies that simultaneously addresses fragmentation in patient care delivery, improves adherence to therapies, and increases patient consumer satisfaction. Life sciences organizations are investing $14 billion annually in patient services and the growth of this market segment is outpacing the overall growth of the healthcare sector.

Systemic fragmentation has long been considered the root of the challenges in the American healthcare system with misalignment of incentives, lack of coordination, and gaps in patient care. To address this fragmentation, integrated delivery systems have been promoted as the solution to create a more seamless patient experience by connecting healthcare providers in organized and collaborative networks that can deliver a coordinated, vertical continuum of services to patients.¹ However, restructuring the complex U.S. healthcare system towards an integrated, vertical model is a tall order, and may not be the easiest way forward. It may require major changes in healthcare policy that don’t appear feasible in the current political environment.

Rather than pursuing an overarching political solution to the problem of fragmentation in healthcare, igniting the dynamics of the market forces may be a better path forward.

With the growth in digital, personal technologies and patients increasingly behaving as informed consumers, the forces of market dynamics are gradually driving changes in healthcare delivery that will help simplify care delivery, connect services, and improve the consumer experience.

Patient services is the new, rapidly growing business segment building on these trends. Patient services can ease the burden of the patient journey by providing a range of consumer-focused services, including patient communities, access and reimbursement services, patient support programs, financial support, patient assistance programs, and in-home patient care, including in-home nurse clinical educators and in-home phlebotomy services.

Patient services typically involve diverse stakeholder groups within a life sciences organization, including brand, marketing operations, access and reimbursement as well as patient support and patient engagement. Companies are already investing $14 billion a year in these services, with spending growing at an annual rate of 17%, which outpaces the growth of the overall healthcare sector.²

What are the market dynamics driving this trend?

Several factors are driving this trend:

• Chronic diseases. More patients with chronic conditions who need to utilize complex, high-cost, poly-therapies. A total of 67% of patients have multimorbidity, the coexistence of two or more chronic conditions, which increases with age, from 50% for persons under the age of 65, 62% for those between the ages of 65 and 74, and 81.5% for those aged 85 or older.3
• An aging population. The number of older persons worldwide is projected to double to 1.5 billion by 2050, and the aging population demands more patient-centric healthcare services.
• Patient non-adherence. It is estimated that patient adherence to chronic medications is only about 50%, which can account for up to 50% of treatment failures, around 125,000 deaths, and up to 25% of hospitalizations each year in the United States.⁴
• Virtual health. The growth in telemedicine and digital tools to fill care gaps has been driven the by impact of the COVID-19 pandemic.

Patient services can make a real difference in the lives of patients

Patient services plays an important role in reducing the burden of disease and improving the patient experience through a suite of consumer-focused services. For any company with a specialty treatment, the question isn’t whether or not to offer patient services. The questions is: What is the right blend or services and the right time and channels to deliver them?

Three practical examples demonstrate the value of patient services:

Clinical nurse educators improved adherence among patients with multiple sclerosis

For Multiple Sclerosis (MS) patients, consistent medical treatment may slow the onset of the progressive disease’s devastating symptoms, provide supportive intervention to address the unpredictable rhythm of the disease, and keep patients on their prescribed therapy. In partnership with a pharmaceutical manufacturer of MS drug therapies, a customized Patient Support Program was designed to address the barriers to therapy adherence from a holistic perspective.

The company’s annual patient adherence rates to an MS injectable medication were below their target goal, meaning the patients were at risk to experience faster disease progression.

A team of MS clinical nurse educators were put in place to supplement the company’s in-house support team. Through the Patient Support Program, the MS patients received regular, customized nursing contact and gained a greater understanding of their prescribed therapy. Patient surveys revealed very high levels of satisfaction with the program, and more than a 42% improvement over home healthcare agency educators regarding whether patients received a “clear explanation of long-term therapy.”

When the MS patients were able to understand their treatment and increase their own motivation for taking it, the company saw a 99% patient acceptance rate and 96% adherence to treatment.⁵

Patient services can foster a seamless patient experience

Patient support program reduced abandonment and lowered medical costs

Many chronic diseases require treatment regimens that involve multiple providers, complex fulfillment hurdles with confusing payor limitations, intimidating methods of administration, and the overwhelming prospect of lifelong adherence. A U.S. pharmaceutical company was experiencing high treatment abandonment among patients of chronic diseases, so they sought help in developing a Patient Support Program to identify and address the barriers patients experience in regard to obtaining the medication prescribed and adhering to a potential lifelong therapy.

The Patient Support Program provided individualized support and education based on patient-specific barriers in obtaining and/or adhering to their medication treatment plan. Each patient received a customized experience based on their individual needs.

The company achieved its primary goal of educating and informing patients, which led to a reduction of prescription abandonment, increased adherence, and deceased medical costs for the patient. The program reduced medication abandonment by 14% and lowered medical costs to the patient by 23%.⁶

In-home phlebotomy service improves patient adherence

Patient support programs help patients overcome barriers to adherence to prescribed therapy. One common hurdle in patient adherence is the need to assess and monitor lab values from blood draws. Lab workups may be necessary to determine a patient's eligibility for treatment, to establish the proper dose, or to monitor safety for therapy maintenance. Unfortunately, the need to go to a lab to have blood drawn can add to the treatment barriers that already exist for a patient.

A remote phlebotomy service, can be key to helping patients start, and stay on, prescription drugs for which there are requisite clinical standards that can only be determined through a blood draw and laboratory workup.⁷

In-home phlebotomy services are frequently used during decentralized clinical trials and can also be easily deployed in post approval to support therapy initiation and maintenance throughout the patient journey.

The illustration below shows how in-home phlebotomy services works.

Benefits for multiple stakeholders

Patient services has the potential to deliver benefits simultaneously to multiple stakeholders in the healthcare ecosystem:

• Patients can gain the benefits from reducing the burden of disease by staying adherent to therapies and improving their experience.
• Prescribers and healthcare providers can improve treatment outcomes and efficiencies of care.
• Payers and insurers can gain efficiencies from improved outcomes and reduced losses from patient non-adherence.
• Pharmaceutical companies can minimize the loss of value from patient drop-offs, especially in niche, specialty, and rare disease markets.
  

References

1. Enthoven AC. Integrated Delivery Systems: The Cure for Fragmentation. m J Manag Care. 2009;15:S284-S290. https://pubmed.ncbi.nlm.nih.gov/20088632/
2. IQVIA Market Access Library; LAAD 2013-2020.
3. Salive ME. Multimorbidity in older adults. Epidemiol Rev. 2013;35:75 https://pubmed.ncbi.nlm.nih.gov/23372025/
4. Kim J et al. Medication Adherence: The Elephant in the Room. US Pharm. 2018;43(1)30-34. https://www.uspharmacist.com/article/medication-adherence-the-elephant-in-the-room#:~:text=Typically%2C%20adherence%20rates%20of%2080,chronic%20medications%20is%20around%2050%25.&text=Adherence%20rates%20can%20go%20down,as%20barriers%20emerge%20or%20multiply.
5. IQVIA Case Study. Patient Support Program Improves MS Patient Adherence. https://www.iqvia.com/-/media/iqvia/pdfs/us/case-study/psp-case-study-ms-adherence.pdf
6. IQVIA Case Study. Patient Support Program Reduces Abandonement and Lowers Medical Costs. https://www.iqvia.com/locations/united-states/library/case-studies/patient-support-program-reduces-abandonment-and-lowers-medical-costs#:~:text=IQVIA%20Patient%20Support%20Programs%20reduce%20abandonment%20rates%20and%20lower%20medical%20costs.&text=When%20patients%20were%20able%20to,and%2023%25%20lower%20medical%20costs.
7. Stoy, Robyn. Overcoming barriers to patient adherence. BioPharma Dive. Dece,ber 14, 2020. https://www.biopharmadive.com/spons/overcoming-barriers-to-patient-adherence/591821/

Kathi Henson, VP, Patient Support & Nursing Services, IQVIA