Reducing Barriers to Great Patient Care and Supporting Product Success

Richard Tremonte

Every day, manufacturers bring life-saving therapies to market. However, without strong relationships with providers, the commercial and clinical success of the product may be at risk. After all, if patients do not have access to or are not taking their therapy properly, its efficacy is irrelevant. Manufacturers rely on providers to ensure that patients are knowledgeable about their therapy, staying adherent to the medicine and working closely to address potential side effects. As manufacturers look to commercialize new medicines, it is important to evaluate partners that can provide a fully integrated offering aligned to product performance goals and offer a seamless customer experience. In addition, it’s important to evaluate partners that have close relationships with providers that can offer patients the expertise and resources to improve their health, which in turn, supports product success.

With this in mind, manufacturers should not underestimate the role of the pharmacist, particularly those located within independent community pharmacies, as they evaluate their commercialization plans. These pharmacists serve a unique role as both members of the health care team and the communities they serve. They can provide patients with information to understand their diagnoses, manage their medicines, and live healthier lives. The role of community pharmacists is also continuing to expand beyond the walls of the pharmacy. For example, pharmacists have begun to conduct onsite medication therapy management with patients receiving inpatient care at a local hospital, helping them understand their therapy regimen and why it is important as they transition back to their home.

At the same time, the behaviors of patients have evolved, creating a greater need for personalized care. Pharmacists often see their patients an average of 35 times per year, compared to the three or four times a year a clinician might see a patient.[1] With such frequent patient interaction, pharmacists are forging the meaningful relationships with patients that are necessary to influence adherence and deliver care in a complex health care system.

Independent community pharmacists are already providing the types of services that help manufacturers support patients and achieve market success, and their role helping to meet the needs of both patients and manufacturers will only continue to grow. According to a recent AmerisourceBergen survey, the Pharmacy Check-Up: Activity & Barriers to Care Analysis, at least half of independent pharmacists expect they will spend more time helping patients manage access challenges (50%), counsel patients (57%), and support medication therapy management (68%) over the next five years.

Solving challenges to good care

The Pharmacy Check-Up survey, however, also found that 84% of independents reported that collaboration with manufacturers is a barrier to care. Lessening the friction across the supply chain makes it easier for manufacturers and pharmacists to reach the shared goal of supporting patients. By focusing on the following three opportunities, manufacturers can work with pharmacies to continue increasing the quality of care for patients and overcome barriers to care:

• Lowering non-adherence rates. Patients value the relationships they have with their pharmacist. The personalized support independents deliver distinguishes them from other providers, making them a unique health care destination. One of the most significant health challenges that pharmacists are uniquely positioned to address is non-adherence rates. Recent studies have shown that between 33% and 69% of all medication-related hospital admissions could be attributed to non-adherence.[2]

Because of their relevance and proximity to patients, community pharmacists can engage with a patient, educate them about their medications, and ensure they are refilling their scripts at the right time. Independent community pharmacies are also leading the way as it relates to adherence programs, with 64% employing MedSync or other approaches to streamlining the number of visits a patient has to make and reducing the complexity of managing multiple medications.[3] The National Community Pharmacists Association found MedSync patients are more than twice as likely to be adherent to their medications.[4] An adherent patient not only benefits the pharmacy, which will receive a constant flow of business, but also the manufacturer whose goal is to keep patients on therapy and improve patient outcomes.

• Educating about the future of specialty. Patients with more complex health care needs tend to seek out the tailored care and close relationships provided by independent community pharmacists. In fact, data from AmerisourceBergen’s PSAO, Elevate Provider Network, suggest patients pick their pharmacy before selecting their health plan. As more specialty medicines enter the U.S. market, there is an opportunity to leverage the pharmacies that have already built these crucial and lasting relationships. For example, selective self-administered specialty treatments can be distributed through the pharmacy, where patients can engage their pharmacist to learn more about their new medicine and have a supportive environment in which to maximize the therapy through improved adherence.

The emergence of biosimilars is an opportunity for manufacturers to educate pharmacists-a trusted resource for patients-and increase access to care. While biosimilars may not be administered within a pharmacy, manufacturers should consider the implications of patients consulting with their pharmacist as they learn more about the availability of biosimilars. In addition, we’re seeing interesting trends in the pharmacy space where pharmacies are adding on things like infusion clinics, labs, and more to provide patients with more comprehensive offerings. Recognizing pharmacy’s potential influence and evolution, manufacturers should consider offering more education for pharmacists even before a product’s launch. This education and increased engagement between pharmacists and manufacturers, as well as providers, could support more widespread interest in and adoption of biosimilars, particularly as more are approved in the U.S. and we all continue to look for more cost-effective, yet innovative, care options.

• Leveraging strong distributor relationships. Every day, pharmacies work closely with their distribution partner to ensure they have the products their patients need. A strong relationship between a pharmacy and the distributor is beneficial to manufacturers as the distributor supports the goals of both parties and reduces inefficiencies. Distributors can help a manufacturer better understand the needs of a pharmacy and the patient population it serves so that the manufacturer can ensure its products are best supported.

Distributors also offer financial flexibility benefitting both manufacturers and pharmacy providers. In fee-for-service arrangements, wholesalers take financial ownership of a manufacturer’s product and become responsible for collecting payment from individual provider customers across the country. At the same time, they offer pharmacies with tight cash flows through short-term financing to help cover the cost of carrying inventory between dispense and reimbursement. Because of this system, patients can feel confident that their provider will have the product they need when they need it.

As the link between manufacturers and independent pharmacists, distributors understand the entire lifecycle of both the medicine and the patient and can eliminate barriers between the two.

As manufacturers bring new therapies to market to improve care, it is imperative to constantly ask-what is best for the product and the patient? In asking those two questions, manufacturers will increasingly find that part of the solution is independent community pharmacy. These pharmacists are well positioned in not only the communities they serve but also the lives of the patients they support. If appropriately considered and engaged, they represent an important opportunity for manufacturers to both improve care and encourage product success.

Rich Tremonte, Executive Vice President and President, Community & Specialty Pharmacy at AmerisourceBergen

[1] Moose J, Branham A Pharmacists as influencers of patient adherence. Pharmacy Times website. www.pharmacytimes.com/publications/directions-in-pharmacy/2014/august2014/pharmacists-as-influencers-of-patient-adherence-. Published August 21, 2014.

[2] Rosen OZ, Fridman R, Rosen BT, Shane R, Pevnick JM. Medication adherence as a predictor of 30-day hospital readmissions. Patient Prefer Adherence. 2017;11:801-810. Published April 20, 2017.

[3] Michos, Leon. “NCPA Community Pharmacy Start-up Benchmarking Report.” National Community Pharmacists Association, PCCA, 2017, www.ncpa.co/pdf/2017-ncpa-startup-report.pdf.

[4] Painter, Jacob, et al. “Addressing Medication Non-Adherence through Implementation of an Appointment-Based Medication Synchronization Network.” National Community Pharmacists Association, Ational Community Pharmacists Association in Cooperation with the Arkansas Pharmacists Association and Support from Pfizer, ncpa.co/uploads/Arkansas-Report-Final.pdf.