Budget Planning: Creating Impact with Less Investment

Declining Patient Adherence is a Key Concern

It’s August and many of us are in the midst of budget planning season. We are all aware of the reality facing the life sciences industry—more drugs coming off patent leading to less revenue and increasing costs to develop new treatments. Now more than ever, life science companies are faced with the need to do more with less. For marketers this means maximizing the impact of each program.

My advice to clients is to initially focus on programs that are quick to impact such as patient retention, attracting appropriate patients to consider your product, and maximizing the efficiency of your sales force. Below are a few specific programs you should consider.

Begin with patient compliance and adherence to therapy. It has been reported that compliance to therapy averages between 50% and 65%. There is a tremendous opportunity to increase the number of patients that adhere to treatment. The added benefit is it is much less expensive to keep patients on treatment than it is to attract new patients. To increase patient compliance and adherence consider…

* Patient support programs—these programs focus on patients and help them meet their needs and overcome their challenges. As a pharmaceutical call center we have healthcare-trained representatives available 24/7 and 365 days/year to answer patient questions and provide materials about their condition, treatment, side effects, and even can direct them to reimbursement assistance programs if they need it.

Support DTC marketing efforts and make it easy for patients to act on the awareness built by the advertising campaigns. To increase the effectiveness of your DTC marketing programs consider…

* Adding pharmaceutical call center support to handle inquiries from your advertising campaigns. A pharmaceutical call center we can answer patient questions, and can also provide referrals to physicians and specialists located near the patient’s home or work.

* Including click-to-chat support through websites. Make it easy for patients to ask questions and receive quick replies when they are interacting with one of your websites. Click-to-chat functionality provides real-time interactions, which is a tremendous advantage. As a pharmaceutical call center we can provide healthcare-trained representatives to answer patient questions submitted through websites and can provide links to materials and referrals to physicians and specialists too.

Maximize your field-based sales force so they focus on providing value to healthcare providers. To increase the effectiveness of your field-force consider…

* Partnering with a pharmaceutical call center to drive action with healthcare providers such as booking appointments for sales representatives and enrolling sites in a study or patient support program.

* Shifting administrative tasks such as replenishing samples and overseeing distribution and fulfillment. Our call center representatives reach out to healthcare providers on a regular basis to ensure they have adequate supplies of samples and materials. Additionally, we can oversee database updates and targeting and cleansing activities too.

The challenge to do more with less will continue for the foreseeable future. The formula for success is to create the most value from our investments. There are many opportunities to create value, and I have shared a few of my thoughts on how a pharmaceutical call center partner can help. I’d like to hear from you. What are your challenges? How are you creating more value for your investment?

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Free Podcast: Improve Patient Adherence with Patient Support Programs

 In the latest podcast, I share my thoughts on improving patient adherence through patient support programs. Specifically, I discuss how patient support programs contribute to higher patient compliance rates, better patient health, lower healthcare expenses, and improved patient retention.

If you would like to listen to this podcast, please click to download it now. After you listen to the podcast, let me know what you think of it—is it helpful? Are you currently providing patient support programs? If so, please share your experiences and insights on these programs. This area is evolving quickly, and we can all learn from one another.

We also recently published a free white paper titled “Increase Patient Adherence and Do More with Less”. We encourage you to download this companion piece to the podcast.

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Fact: Healthcare Is Changing

Efforts to reform healthcare are moving forward as it is clear that as a nation we must decrease healthcare costs. Right now there are more questions than answers about the impact of the Affordable Care Act (ACA) that the US Supreme Court recently upheld. One thing is clear—the US healthcare system is changing. Below are my thoughts on three key areas the life science industry must prepare for.

Articulate the value of your product.

Conventional end points of safety, efficacy, and quality of life are no longer sufficient. Be prepared to demonstrate cost-effectiveness or cost-avoidance.

Implementation tips...

1) Work collaboratively with your colleagues in marketing, managed care marketing, pharmacoeconomics, clinical affairs, medical affairs, and regulatory to understand the data that is desired by various stakeholders when they are determining if a product is valuable or not. Develop plans to obtain the needed data.

2) Determine which patients are most likely to benefit from your product. Communicate to healthcare providers the patients that are most likely to benefit from treatment. Additionally, assist with screening and referring appropriate patients to local physicians or study sites.

Plan for government rebate plans and pricing controls.

If your treatment is expensive, be prepared for limitations on its use compared to less expensive alternatives.

Implementation tips...

1) Adjust your forecasts

2) Begin working on how to articulate the value of your product (see above for insights)

Provide programs that enhance outcomes for individual patients.

Shift your focus to taking care of patients and improving their outcomes. Patients will stay on treatment and future healthcare expenses resulting from patient non-adherence will decrease.

Implementation tips...

1) Plan and implement programs that support patients on their treatment journey.

2) Understand the barriers patients face in remaining adherent and compliant with therapy.

3) Develop and implement patient support programs that are a resource and guide for patients during their treatment journey. This can include offering access to healthcare-trained representatives for questions or providing educational materials to help patients continue with treatment.

There are many ways you can articulate the value of your product. Additionally there are many options for providing programs that enhance patient outcomes. As a pharmaceutical call center, we provide as needed call-in support for patients, caregivers, and healthcare providers to answer questions about a product and its side effects, enroll patients in a support program, connect patients with healthcare providers in their local area, and connect patients with co-pay assistance resources. Our experiences show that within 6 months of implementing a patient support program patient adherence increases 10% to 15%. Patient adherence to treatment decreases future healthcare costs related to treating complications from earlier non-adherence.

The June 2012 issue of PharmaVOICE magazine has an article on healthcare reform and the potential impacts of it on the life science industry. If you are interested in additional perspectives on the impact of healthcare reform you can access the article here.

I’d like to hear from you. How are you preparing for the impact of the ACA? What areas have you identified as opportunities? What kinds of initiatives and programs are you planning? Please join the conversation and share your thoughts, challenges, and questions on the ACA implementation. We can all learn from each other.

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White Paper - Do More with Less—Invest in Patient and Caregiver Support Programs

A successful model

Patient adherence is a hot issue for all players (ie, payers, healthcare providers, life science companies, and patients) in the healthcare industry. Unfortunately all chronic conditions have low rates of patient compliance to therapy with the average being between 50% and 65%. Patient noncompliance is a significant problem, and for the life science industry it is particularly problematic as patients that start a therapy are not likely to continue it for the needed duration. This has a significant financial impact for life science companies as it costs six times more to attract new patients than it does to retain existing ones.

We have seen adherence rates increase by 10% to 15% after a patient and caregiver support program is implemented and maintained for one year. Increasing patient adherence is a win:win:win situation. Patients gain better health and enhanced quality of life, payers decrease expenses treating future healthcare issues that arise from non-compliance, and life science companies retain patients on therapy.

In our patient and caregiver support programs we have seen significant demand from patients for personalized experiences and information. The days of developing and disseminating materials for the masses are ending. Rather, patients want information specific to them, their condition, and needs.

Opportunities for providing patients with personalized information abound, and I have recently published a white paper on how to develop successful patient and caregiver support programs, as well as emerging trends being used to deliver customized and personalized experiences for patients. Patient and caregiver support programs can help life science companies retain patients on treatment and create real value for patients, healthcare providers, and payers.

If you’d like a copy of the white paper titled “Increase Patient Adherence and Do More with Less,” please click to download it. Please let me know what you think of this latest white paper—is it helpful or not? Also, let me know what areas you’d like to see more information and recommendations on.

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ASCO Highlights: Two Innovative Trial Designs

 
The annual scientific meeting for the American Society of Clinical Oncology (ASCO) recently concluded. As expected there was a constant flow of new data being released for products in various stages of development for all forms of cancer. The volume of new data is exciting, even though the decks are stacked against these approaches and their odds for commercial success are slim.

As I scanned articles summarizing data presented at the meeting two studies stood out to me because they have superior efficacy data, but also data on endpoints that answer the question of “value”. These two studies demonstrated bold thinking on the behalf of the companies. First, these companies designed products that are tolerable and don’t take away from patients’ quality of life, which is unheard of for the majority of cancer treatments. Additionally, these companies designed clinical trials to demonstrate efficacy and tolerability, which provides meaningful and valuable data to physicians, payers, and patients.

To proactively seek data to differentiate a product is a risky move. However, this is exactly what payers, physicians, and patients are asking for. We are going to see more of this in the future. The studies also demonstrate the importance of meeting patients’ strong desire for efficacious, tolerable, and safe drugs.

These are tremendous first steps, but in thinking and acting boldly, let’s do more to support patients and caregivers during treatment. We all know the time constraints on healthcare providers, an additional opportunity for life science companies is to provide robust patient and caregiver support programs that educate, inform, and guide patients. Treating cancer is a difficult journey. The more support patients receive the more likely they are to remain on treatment, which dramatically improves their outcomes.

Are you interested in knowing the two studies presented at ASCO that jumped out to me? They are…

1. The study GSK launched in patients with renal cell carcinoma evaluating patient preference for Votrient® (pazopanib) and Sutent® (sunitinib). In the study pazopanib (a late entrant into the market) went head-to-head against sunitinib (the 1st line treatment of choice). Both products have similar efficacy rates. The head-to-head study showed that 70% of patients who completed both treatments prefer pazopanib, 22% of patients that completed both treatments prefer sunitinib, and 8% of patients did not have a preference. The primary reasons patients preferred pazopanib were 1) better quality of life, and 2) less fatigue. This study demonstrates the value of evaluating not only efficacy data, but also patient tolerability preferences too.

2. The Roche/Genentech study with TDM-1, which is the Herceptin® antibody trastuzumab combined with the cytotoxic emtansine. The study of this investigational compound versus Xeloda® (capecitabine) + Tykerb® (lapatinib) in patients with HER2+ relapsed metastatic breast cancer showed a progression-free survival benefit with TDM-1, and lower rates of Grade 3 adverse events (41% versus 57%) and very little gastrointestinal toxicity. This study demonstrates the possibility of developing an efficacious product that has decreased side effects.

I’d like to hear from you. Have you considered, or are planning, a head-to-head trial in order to demonstrate your product's unique differences? Also, what ASCO presentations stood out to you? Please share the studies and why you think these are important trials.

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ASCO: Celebrate Successes and Prepare to Support Patients in the Future

The annual scientific meeting for the American Society of Clinical Oncology (ASCO) starts this weekend in Chicago. This meeting is the premier scientific meeting for new clinical data in oncology. Reflecting on this important meeting I’m reminded of the significant advances that have been made in the last 15 years in treating cancer. Several trends fill me with hope for the future, including…

1) Increasing use of oral therapies
2) Molecularly targeted therapies offer decreased side effects versus traditional chemotherapy
3) The possibility that cancer, in many cases, can be treated as a chronic condition with an emphasis on on-going therapy

Cancer treatment is certainly much more effective, manageable, and tolerable than it was 15 years ago. While there are many advances in oncology treatment to celebrate, significant challenges remain including…  

* Patient adherence to treatment—As more oral treatments are used for treating cancer, patients and their caregivers take on a greater role for ensuring treatments are taken regularly and at prescribed doses. With treatments administered in a physician’s office or medical center the nurses see patients regularly and ensure treatments are administered as prescribed and at appropriate times. 

* Changing needs of patients and caregivers—As patients and caregivers take on more responsibility for administering treatments, they are also taking on more responsibility for monitoring and managing side effects to treatment. This can be a frightening responsibility for caregivers and more can be done to support them in this role.  

* Increased costs for treatment—On average targeted therapies cost significantly more than traditional chemotherapeutic agents. The increased cost is an issue for all stakeholders involved in oncology treatment including patients, caregivers, healthcare providers, payers, and life science companies. Patient co-pay and financial assistance programs are critical in helping many patients pay for their treatment.

For life science companies these challenges are significant, and they are also opportunities to engage with patients, caregivers, and healthcare providers. To begin, ensure you…  

* Understand the patient’s treatment journey, and in particular, the barriers they face in remaining adherent and compliant with treatment 

* Develop and implement comprehensive patient support programs that are a resource and guide for patient’s during their treatment journey  

* Inform and educate healthcare providers on the details of patient and caregiver support programs

As a pharmaceutical call center, we provide as-needed call-in support for patients, caregivers, and healthcare providers to answer questions about a product and its side effects, enroll patients in a support program, and connect patients with co-pay assistance resources. Our Medical Advisory Board works with us to design programs focused on meeting the needs of patients, caregivers, and healthcare providers.

I’d like to hear from you. What challenges does your oncology product(s) face? Please join the conversation and share your thoughts, challenges and questions.

I’ll be in Chicago at the ASCO meeting. If you’ll be at ASCO, please send me an e-mail and we’ll schedule a time to get together. I always enjoy learning about the challenges you're facing.

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Keep it Simple: Focus on the Patient with Adherence Programs

Hi, I'm Moriah Weissman and I'm a Clinical Director at Tunstall AMAC. I work with Lou and our life science company clients to provide clinical insights for the development of patient, caregiver, and healthcare provider support and communication programs. Lou invited me to contribute to the blog, and I look forward to sharing insights and thoughts with you, as well as learning more about your challenges.

In working with our clients there is a lot of interest in life science companies about maintaining patients on a treatment. A number of articles and studies have been published about patient adherence, and I certainly believe patient adherence can be a driver in your business. In looking at many of the patient adherence articles that have been published two thoughts come to my mind…

1. Why do most patient adherence programs seem so complicated?
2. Patient adherence programs are expensive, time-consuming, and difficult to implement!

Many of the patient adherence articles quickly become lost in the data, in analysis paralysis, or in defining whether or not a program is truly patient adherence based solely on whether or not it’s driving “behavior change”.

Perhaps I have over simplified the definition of patient adherence. To me, patient adherence is keeping a patient on a specific treatment. There are many ways this can be done, and certainly I agree that it’s important to embark on a discovery process that helps you to understand the patient journey and a patient’s desire to manage their condition. Without this it’s easy to develop a program that doesn’t drive the right actions. In fact an earlier blog post by Lou Shapiro provided suggestions for understanding the patient journey and resources for understanding a patient’s desire to manage their condition.

I believe two critical success factors for effective patient adherence programs are…

1. Develop meaningful programs that engage patients.
2. Collect feedback and data so the program can be continuously improved.

We offer four straightforward solutions to help our clients build effective patient adherence programs. These include…

1. Our focus is the patient. Start with the patient and keep them, and their needs, at the center of your solution.

2. Our AMAC Medical Advisory Board. We have relationships with healthcare providers in a number of therapeutic areas. We engage these experts to help us understand a particular disease-state/condition, current care delivery models as well as patient needs and challenges. We then work with our Medical Advisory Board to develop custom healthcare communication solutions that meet patients’ needs.

3. Our clinical program directors. They have advanced life science degrees in nursing and pharmacy. We tap into their clinical expertise to understand the patient journey and barriers to treatment as well.

4. Our pharmaceutical call center operators. They talk with healthcare providers and their offices, as well as patients and caregivers each day. They hear first-hand about the challenges patients have in managing their condition. Whether the challenges have to do with side effects, dosing, or cost, our call center operators can describe in detail what the obstacles are that patients face.

To build an effective program we take these insights and evaluate them against the product’s goals and needs. Next, we start putting together solutions that we, as a pharmaceutical call center, can provide. We also work with our clients to integrate other services, such as customized direct mail fulfillment, as appropriate.

Of course, I’ve simplified our development process for the sake of keeping this post brief. And my point is this: patient adherence programs are not rocket science. They can be straightforward and still be effective. I’m willing to bet that if you keep the patient, and their needs, at the center of your solution it will be a success.

Now, I want to hear from you. Do you agree, or do you think my oversimplified approach is wrong? Join the conversation and share your thoughts, challenges and questions.

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