By: Erica Conroy, Ph.D., Vice President of Specialty, CoverMyMeds and Heather Morel, Ph.D, MBA, Senior Vice President and General Manager, Access and Adherence, RxCrossroads by McKesson
Navigating through complicated requirements for starting specialty therapies can be difficult even for health care experts, let alone patients hoping to be well. At the center of the health care ecosystem, hub services are uniquely positioned to help.
Unfortunately, few patients are enrolled into these services, leaving many to struggle through on their own. In fact, it’s estimated that only one out of five patients are aware of hub services.1 Lack of provider and patient awareness as well as outdated communication channels such as phone calls and faxes limit hub engagement.2
Together, CoverMyMeds, and RxCrossroads by McKesson have joined forces to address the challenges associated with traditional hubs through a new technology-driven solution, AMP: Access for More PatientsTM, that sets a new starting point for patient access to specialty therapies through hub integration into CoverMyMed’s active network. This network includes more than 700,000 providers, payers representing 96 percent of prescription volume, 96 percent of pharmacies and over 200 life science brands – allowing us to help nearly 5 million patients per month. The deep specialty expertise, commercial solutions, and high-touch patient support services from RxCrossroads by McKesson, further reinforces the value of this solution.
Through our network connection with providers, enrollment can now begin at the point of prescribing so that all patients can be supported on their journeys, from access to adherence. From the moment an e-prescription is written, patient enrollment into AMP services begins electronically within the central CoverMyMeds portal that is already the trusted medication access solution for 700,000 providers and their staff – ensuring rapid adoption. In fact, 94 percent of providers in certain therapeutic areas have used this same portal within the last 90 days for electronic prior authorization requests.3 Patients learn about support and are automatically enrolled through a preferred2 and trusted source, their provider.
With omni-channel enrollment through AMP, providers can complete patient enrollment however they feel most comfortable, whether that be electronically (via e-prescription within their electronic health records system), on-line through the central CoverMyMeds web portal, or by traditional methods, like fax. As a result, potentially five out of five patients prescribed specialty medications can be supported on their journey.
This self-service platform is configurable within provider workflows and saves time through form auto-population and e-service connectivity. Through an online dashboard, all stakeholders have visibility into which steps need to be completed and who is responsible. Beyond usual care coordination, patients are directly supported through copay offset solutions, educational materials, lab scheduling, automated reminders and help with prescription refills.
Driven by technology, human intervention is now an exception within a standardized AMP workflow for specialty medications – allowing us to coordinate care for all patients through a streamlined process that helps improve time to therapy, medication adherence and patient outcomes. Always available to handle potential complications, case managers and support specialists from CoverMyMeds and RxCrossroads are seamlessly integrated into the platform to immediately step-in to support challenging patient access cases.
The Patient Journey
Without streamlined enrollment into support services, patients can slip through the cracks – abandoning treatment or never starting it in the first place.4 We spoke with several patients to learn about their experiences with illness and specialty medications.5
Let me introduce Robin.* She is a working mom recently diagnosed with multiple sclerosis (MS). She works through financial, emotional and personal stress while coming to terms with what the diagnosis means for her life.
As Robin’s provider tries to help her understand the MS diagnosis and available treatment options, she experiences information overload and uncertainty. Who can I trust? What is the best treatment option for me? How much will treatment cost?
When Robin is prescribed a specialty medication, the enrollment process for patient services begins automatically in the CoverMyMeds portal. Rather than ensuing confusion, as was typical in the past, everyone now has visibility into which steps need completed and who must act to move the process forward.
Robin’s provider and office staff can update her on completion progress while electronically fulfilling enrollments steps, including lab requirements, benefits investigation and verification, prior authorization, eligibility for financial assistance and script triage to an appropriate specialty pharmacy among others. Together, these steps could require upwards of 70 touchpoints among health care stakeholders.6 Instead of phone calls and faxes, these transactions can occur electronically for administrative time and cost savings.
To Robin, the entire process is seamless, and her therapy begins without delay.
Flipping the Script on Medication Access
On her own, Robin’s journey is difficult. With AMP, her story and millions of other patients’ can be different. A recent case study of program performance demonstrates the difference that AMP makes for patients. In two-months’ time for a specialty medication treating a narrow patient population, time-to-therapy was reduced by 27 percent and 89 percent of providers on a prospective list enrolled a total of ~1,250 patients into AMP. Adoption of electronic enrollment by providers was also encouraging, with approximately half of enrollment forms completed electronically. As providers start recognizing the ease-of-use and time savings benefits of AMP, we expect numbers to climb even higher.
To learn more about how CoverMyMeds and RxCrossroads by McKesson are modernizing medication access and adherence, visit go.covermymeds.com/amp.
*Robin is a persona created to summarize the similarities we heard while interviewing patients.
Sources
- Patient Services – Pharma’s Best Kept Secret, Accenture Life Sciences, 2015
- The Patient Is IN – Pharma’s Growing Opportunity in Patient Services, Accenture Life Sciences, 2016
- ASHP Specialty Pharmacy Resource Guide
- The Impact of Disease-Modifying Therapy Access Barriers on People With Multiple Sclerosis: Mixed-Methods Study
- CoverMyMeds data on file, 2019
- CoverMyMeds data on file, 2019