Patient Treatment & Travel: The Need for Stepped-Up Support

Christine Isbell, Managing Partner, SeaMI Strategies, LLC

Viviana Brun, Subject Matter Expert, Hub & Patient Services, Diligent Health Solutions

Drug manufacturers have a long-standing history of providing hub support to help patients navigate the path to product access, effectively utilize their insurance coverage, and understand what other support may be available. But for certain types of therapies, more is needed.

This is particularly true for cell and gene therapies, which may require a days-long stay at a treatment center that is often in an unfamiliar city or town, far from the patient’s home. Manufacturers can provide help by offering patients and caregivers high-touch services for travel and lodging associated with the required treatment.

A prerequisite to offering such services is the creation of a comprehensive and detailed policy. It is most often developed by the functional area within the company responsible for its administration (typically patient services); however, it should be reviewed and approved by other stakeholders, including legal counsel. If a third party is responsible for the execution, their guidance and input should also be sought. The policy should answer the following questions:

1. What are the eligibility requirements for participation? Typical considerations are country of residency, enrollment in the company’s official assistance program, household income, insurance status, and distance from the treatment center.

2. Are the expenses of a caregiver eligible for assistance? Inclusion of a caregiver is standard when the patient is a minor, but should also be considered in support of adult patients.

3. What is the financial limit of the support? This is a dollar amount beyond which assistance will not be provided.

4. How long before and after the stay in the treatment center will support for lodging be provided? Patients will often travel a day or two before admission to the center and (for medical reasons) stay in town a day or twobefore traveling home.

5. What expenses are covered beyond actual travel and actual lodging? For instance: mileage to get to the airport, car rental, parking, restaurant meals, and food purchases.

6. What expenses are directly paid and which are reimbursed? Often, the actual travel and lodging are directly paid and other expenses are reimbursed. A reimbursement process (involving submission of receipts by the patient or caregiver) will need to be defined.

7. What documents are needed to enact the policy? For instance: an application in which the patient/caregiver requests travel and lodging support, a form that documents each eligibility requirement is met, and an approval form that allows for the initiation of services.

It is essential to have the right team of highly-trained travel and lodging specialists performing the services defined in the policy. The specialists must know the processes inside and out, and be highly knowledgeable about the medical condition and therapy. They must know how to recognize and document adverse events and product complaints, as these will likely be reported in some of their communication with patients or caregivers.

The specialists must also be highly collaborative. They will work hand-in-hand with the treatment centers, who often have recommendations and/or special arrangements with local establishments that can be shared with patients and caregivers.

Here are some actions taken by the specialists that can make a real difference in the lives of patients and caregivers:

Research travel and lodging options; present to patients and caregivers verbally and in writing.

Make reservations for “direct pay” expenses and send confirmation.

• Research car rental options.
• Check in prior to travel to make sure all is set.
• Check in shortly after anticipated arrival.
• Check in a day or two prior to trip home to make sure all is set.
• Provide clear direction on submission of reimbursable expenses, track the submission, and alert patient/caregiver when payment made.
• Provide information about other financial resources that can potentially supplement the manufacturer’s assistance program (e.g., foundations, other non-profit organizations).

Prioritizing patient-centric initiatives such as a well-designed and flawlessly executed travel and lodging support program allows pharmaceutical manufacturers to meet patient needs that extend far beyond treatment, fostering a more compassionate and effective healthcare system.

Christine Isbell is Managing Partner, SeaMI Strategies, LLC; Viviana Brun is Subject Matter Expert, Hub & Patient Services, Diligent Health Solutions