Navigating the world of specialty biologic drugs. A top challenge for specialty drugs category has been the complexity of treatment plans for patients, especially in context of managing chronic health conditions with a specialty biologic drug. The problem emanates from opaque and complex care delivery mechanisms to administer the drug and manage frequent approvals and coverage considerations.
A patient is highly likely to be in the care a chronic health condition specialist and a family physician at the time of receiving a prescription for a specialty biologic drug. The pathway to speciality drugs usually involves a series of random treatment alternatives with unpredictable and inconsistent outcomes from patient to patient. Some new prescription drugs may require prior authorization from a provincial health program or their insurer while others may not. Moreover, the drugs are likely to have been ingested instead of requiring special handling or temperature controls.
A key strategy of specialty biologic companies has been to offer patient assistance programs (PAPs) for patients whose treatment plans may include the use of specialty drugs. These PAPs may include a financial assistance component for patients and may include patient education and support. Patient assistance programs often start with an education session with new patients about the specialty drug and process of purchase and use since most are delivered by intravenous at one of three locations: infusion clinic, at a hospital, or by injection at home. The complexity of adjusting to these variables can be daunting for patients and thus, the process of PAP education to provide patients with the right information regarding private drug coverage will accelerate the authorization process.
Patient assistance programs have another benefit after provincial health and private drug plan coverage begins – it helps to increase compliance levels of drug use and also regular check-ins on therapy monitoring and side effect tracking. The programs also increase communication between the prescribing specialist for dosing and medical test scheduling which are essential treatment monitoring mechanics. An example may be a commination of antibiotics for bronchitis during an infusion. In such a situation, the program clinician would connect with the patients physician to ensure the biologic drug infusion is scheduled at the appropriate time to reduce wastage.
An important trend is self-delivery of specialty drugs. In such cases, the patient is trained to self-administer the drug by the PAP nurse. This process includes a robust education component and ongoing monitoring of the patient. The focus of the process is to improve patient health outcomes with education, monitoring and follow up. Another consideration is a requirement for lower cost therapies unrelated to the drug brand. This allows PAPs to decide on the appropriate drugs from a range of available options.
The goal of insurance programs should be to focus their communication on the PAP to ensure qualified care givers screen, monitor and deliver information to patient to manage medication risk and better health outcomes. to integrate with PAPs without duplicating services or creating more work for the plan member. Another emerging step is to coordinate pharmacy setup with the insurers requirements where a provider network or pricing preference is in place. This may allow for greater flexibility in terms of financial support options for patients and augment information flow regarding treatment options and care mechanisms. An important consideration for Plan managers is to ask about authorization processes and financial support mechanisms to ensure the patient experience is not compromised.
Value through better ideas with fact based Healthcare, Life Sciences, Biologics, Specialty Drugs consulting services. Our commitment is to help our clients solve culture, operations and growth challenges. We advise life sciences and healthcare organizations on growth, operations and change management.
Learn more about our services
> Healthcare providers- Hospitals and medical research centers
> Health plans- Commercial and government plans and pharmacy benefit managers
> Life sciences- Pharmaceutical, biotechnology and research organizations
Healthcare Industry – Trends, Research, Analysis:
Our healthcare scan research includes interviews with over 220 C-level executives, 1500 CMO/CTO/CNO and 2130 frontline staff each year on challenges healthcare organizations face in delivery of superior patient care. We have also helped prescription, OTC, biotech organizations with their most challenging operations, people and growth strategies. Learn more about our services in the areas of data services, healthcare trends and more. Read more.
Consultants and expertise:
Biologics: Our Biologics Consulting is a full-service regulatory and product development consulting firm for biologics, pharmaceuticals and medical devices and specialty groups. Our subject-matter expertise is consolidated to provide a comprehensive offering to meet the needs of clients. Read more.
Hospital and Healthcare systems: Our healthcare consultants have years of experience in senior positions at hospitals, government ministries and other healthcare organisations. Their first hand experience is invaluable to clients to help them navigate complex policy, regulatory,procurement and change management challenges. Read More.
Healthcare and Life Sciences Case studies:
- Canada’s largest study of risk management challenges and patient safety in 450 hospitals. We helped the client develop new products and services to meet the needs of healthcare organizations.
- Developed a change management and growth strategy for one of Canada’s leading organizations of Obstetricians and Gynaecologists.
- Marketing strategy increased share of eye care brand by 8% in 2 years.
- Online strategy and marketing tool increased customer loyalty
- Identified new vectors of growth for a brand with an aging customer base
Sales Force Deployment
Data and Analysis Products
Data and analysis products
Illness Activity Notification program
Flexible and low cost market reports
Territory Alignment & Sales Force Deployment: Implementing a sales force strategy through optimized field alignment requires better resource utilization and target coverage. The territory field alignment and deployment process needs to be designed to facilitate better change management and field buy-in.
Medical distribution and market entry assessments: Arcus helps clients who are interested in market entry feasibility and in market assessments. These may include Canadian medical supply distribution consulting and identification of partners. Learn more about medical distribution and market entry services.
Prescription Pharmaceuticals: We advise clients on opportunities in sales force optimization, marketing, patient-physician communication, and pharmaceutical marketing. Because substantial investments in the next blockbuster require strong predictable results, we help clients develop sound business and marketing strategies. We also address issues such as sales force optimization, product launches, DTC advertising, and market research of products.
Insight: A recent study found that high prescribing physicians receive three to five times as many calls from sales reps as they did 10 years ago. Today’s pharmaceutical rep is vying with a massive army of competitors for diminishing physician time. Many sales reps even have to compete with others from their own company.
OTC Medicines: We help clients assess growth opportunities in competitive categories, explore partnerships with consumer product companies, challenges of customer insight mining, and measure the impact on marketing campaigns on sales.
Biotechnology: We help pharmaceutical biotechnology companies identify promising business growth opportunities and assist clients in developing partnership and acquisition strategies.
Medical Products and Diagnostics: The large and diverse challenges in medical products and diagnostics require proven strategies with unique competitive positioning. We work with clients to identify new marketing opportunities based on deep insights from physician, stakeholder and healthcare organization market research.
Click here for our Consulting service offering.
Below is a sample of the range of services that Arcus has provided to clients. Please contact Arcus for case studies and to discuss how we can help you.
Review a sample of our client successes.
- A survey of 2,350 consumers and 1,320 business leaders for feedback on
- Architecting a multi-year change strategy for a Fortune 500 company
- Mentoring a CEO on organizational change
- Excellence transformation of a leading B2B services company
- Creating a new sales deployment model for a healthcare company
- Developing a position evaluation and compensation model for a professional medical association
- Improving services to customer segments by deepening their understanding of customer attitudes
Arcus has been quoted extensively in media on a range of topics and can offer research studies, insights and ideas. Arcus serves as a subject matter expert in a number of functional areas such as growth, change management, human resources, operations, strategic planning across 36 industries. Below are some examples of recent coverage.
- Nordstrom countdown to opening begins – Toronto Star
- No lineups outside stores in five years – BNN
- Black Friday retail, marketing, and cross-border shopping trends – BNN
- Does global expansion need a local flavour? – Globe and Mail
- Art of the Pitch – Protect company’s interests when approaching giants – Globe and Mail
- Off-the-shelf technology or a custom design? – Globe and Mail
Leadership Viewpoint and ideas
Learn from innovative leaders to help your organization grow, innovate and optimize its performance in many areas including HR, Marketing, Sales and Operations.