Amy Grogg, PharmD, Senior Vice President, Strategy & Commercialization, AmerisourceBergen Specialty Group
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From Product to Patient: Shifting the focus of support programs in oncology.
Empowered by the ease with which they can access information, today’s cancer patients seek a deeper understanding about their diagnoses, underlying diseases or health conditions and potential treatment options, as well as the fi nancial implications of clinical decisions made by their prescribers.
But what does it all mean for pharma? In this era of greater healthcare information, transparency and access, manufacturers can find success by engaging patients at an individual level. It’s time for true patientcentricity— a tailored approach to patient support, even for patients that struggle to engage in their own care.
Looking at patients in multiple dimensions
While many patients are highly motivated and empowered, others may not be as motivated — yet these patients cannot be left behind. Pharmaceutical manufacturers must grapple with the age-old problem of how to properly inform and motivate those patients who do not take an active role in optimal healthcare and commitment to adherence goals. Similarly, manufacturers must devise appropriate outreach strategies to support patients who struggle with medical literacy issues, affordability issues and other barriers that could reduce both access and adherence
to potentially lifesaving medications.
For many manufacturers, the first step is to let go of the one-size-fits-all approach to patient support services and begin segmenting patients to understand their capabilities and motivations. All patients are motivated by a variety of internal and external factors, and every patient has a different level of education and a different comfort zone when it comes to medication. Manufacturer-created outreach can take this into account and be both accessible, as well as reasonably understandable no matter what the patient’s educational or socio-economic status may be.
Learning which factors influence which patients can help manufacturers meet the needs of all patients in the spectrum, from highly motivated and empowered patients to those who may need additional intervention and support as they confront the many challenges that follow a cancer diagnosis.
For instance, most patients have a clear preference for either high-tech (e.g., an app that helps keep the patient motivated and organized) or high-touch (personal support, coaching, etc.) forms of support.
By understanding the patient better using proven patient-assessment methodologies, manufacturers can provide more meaningful interactions and time them to coincide with critical moments during the treatment journey.
Patient stratification in the real world
Manufacturers can use a number of different methods or approaches to assess patient engagement or empowerment. Motivational interviewing is one highly effective example, as are quick surveys administered online, by phone or in written format — the results of which can be used to produce a score that categorizes how empowered the patient is with his or her healthcare journey. A score of 1 might mean less motivated; a score of 4 might indicate a highly engaged patient, with gradations within each of those scores that allow patients to be characterized as a ‘high-2,’ a ‘low-4’ and so on.
Having assessed the patient in this way, and in collaboration with the clinical program experts, manufacturers can create more meaningful support tools that are adapted to where weak spots or pain points may be.
The prevailing wisdom is that more highly engaged patients tend to enjoy better adherence to prescribed therapies and improved clinical outcomes. These self sufficient patients can be contacted less frequently and relied upon to find what they need online or perhaps guided only through occasional reminder text messages. On the other hand, a patient characterized with substantially low engagement may not improve,
and this can help to inform the manufacturer on how much high-touch intervention can be justified for the level of investment required.
Typically, manufacturers get the best outcomes when working closely to support Level-2 and Level-3 patients, as these are patients who have the potential to overcome obstacles with access to the right types of support materials or personal interactions.
Ultimately, investing the time and effort to undertake patient stratification pays off, especially as patients themselves recognize that there’s not a one-size-fits-all option when it comes to navigating cancer care.
The key is to design support programs that blend systematic thinking with the ability to execute on an individual, patientcentric level—an approach seen in Lash Group’s adherence solution, Thumbprint.
It’s only then that manufacturers can most effectively support patients under real-world conditions and optimally manage drug efficacy, tolerability and affordability among an increasingly diverse patient population.