Patient services/patient hubs are more and more common for almost every therapeutic area. Although the recent growth in patient services is due to the growth in specialty products, I did do work with Medco in the mid-1990’s developing disease management programs. These programs utilized all the services hub have today – healthcare staff, algorithms to identify and escalate patients when needed, a call center. However, we went further than the typical hub of today – we interacted with patients routinely, not just to improve access to drug but, also to provide information to improve the experience while on the drug. This last piece is what is missing in the typical hub today. What a missed opportunity.
Access – this is the main goal of today’s hubs. Pharmacy Commerce – wwwpharmacycommerce.com – has done a very comprehensive review of hubs in it’s March/April edition – http://bit.ly/2o5FySa. The report has been issued for the last 3 years and documents the changes taking place in the hub over time.
Four trends dominate the hub services field today:
A greater emphasis on assisting prescribers in helping their patients, especially regarding prior authorization (PA) paperwork
The rush to develop comprehensive data platforms
The drive to one-stop shops offering growing number of services
The effort to broaden hub services to lower-cost or even retail pharmacy drugs, a so-called “specialty lite” effort
There is very little effort to go after the opportunity to create two-way communications with patients or towards behavior changing initiatives. After having worked with hubs I see this as a missed opportunity to build strong relationships with patients and learn more about their lives. If these “beyond the pill” services were implemented it would mean opportunity to solve other looming issues in pharma such as:
- With the advent of performance-based contracting we have learned that it is tremendously hard to define milestones for the performance. The hub is in the ideal position to collect patient reported outcomes (PROs). The PROs would serve as real world milestones that could contribute to defining the success of these contracts, both in costs and health outcomes.
- Improving adherence rates can easily take place within the hub with behavior change initiatives. While collecting the PROs we would learn the behavior patterns in the patient’s lives; we could easily address the barriers, motivate for positive behaviors.
- In clinical trials we have increasing pressure on recruiting diverse populations. Through the hub there could be strong recruitment and retention efforts, Also, with the clinical trial model evolving to include remote monitoring the hub is the ideal place for that monitoring.
Unlike most initiatives in pharma, the hub concept is growing quickly. I would bet that this is due to the opportunity for patient access to drug – the sale is easy to see. The contribution the hub makes to the bottom-line is easy to see. We need to take this to the next level and put in place services that can not only support the acquisition fever in pharma but can also support retention, often elusive in how pharma works.
Let me know what You think,
Dyan Bryson, Patient Engagement Strategist