When you launched your biopharmaceutical product for a rare condition several years ago, you believed your patient services model was sound and would help achieve your goals. Fast forward to today, and the results may not be what you expected. In fact, the performance of your specialty pharmacy (SP) may be mediocre at best.
If that’s your experience, you don’t have to settle for it anymore—and neither do your patients. But you may believe it’s too late to make a change. You’ve invested too much time and money in your current SP and patient services model. You feel it would be too disruptive to your patients and physicians.
That’s a sunk cost fallacy: I’m going to show you why it’s not only okay to make a change—it’s the right thing to do for your patients, physicians, payers and you. You simply need a streamlined way to transition to the model created specifically for patients with rare disorders.
To get started, let’s take a closer look at why your SP may be underperforming—and more importantly—what you can do about it right now.
How traditional SPs underperform
Which of these scenarios sounds all too familiar to you?
- You’re missing forecasts for the number of patients on your medication and number of prescriptions filled.
- Patient uptake is longer than you expected.
- Product utilization is falling short: too many patients are no longer taking their medication as prescribed.
- If you have competing products, your market share isn’t growing.
- Your SP simply isn’t responsive to your needs, as you seek to make adjustments in pursuit of your goals.
Let me focus on this last challenge for a moment. If it’s difficult to work with your SP’s staff, I can promise you patient and physician satisfaction are suffering as a result. If you’re unhappy, it’s certain that patients and physicians are feeling the same way.
Where does this problem begin? I’ve heard feedback from biopharma companies that it’s difficult to contact and get timely service from their SP program supervisor. Often with larger SPs, a coordinator-level person will finally contact the manufacturer; but the coordinator doesn’t have the authority to make decisions, so the issue is escalated and takes much longer to resolve.
In my view, this experience is not always by accident. Traditional SPs want you to do things their way—and if you don’t like it—they believe you’re not going to switch because it’s too difficult.
The root cause of underperformance
Let’s begin with the obvious: taking a mass-market approach to a rare or orphan drug doesn’t work. While it may be ideal for a blood pressure or cholesterol medication that serves millions, It’s the wrong model for a relative handful of people with rare conditions who have unique needs and require a deeper level of understanding and care.
Traditional SPs can forget that there’s a living, breathing person behind the word “patient.” Are they really perceiving the patient as an individual who needs extra attention and handholding? People have things going on in their lives that make them compliant or non-compliant. They’re going to have ups and downs and things you can’t control. Each person is different, and a lot of SPs forget that.
But if you think of patients as people, then you’re thinking of your brother or sister or uncle. Do you want mediocre or barely good enough for them? If not, then it’s incumbent on you to switch SPs. Just okay should not be okay.
Why manufacturers can be reluctant to switch
Manufacturers worry about the potential disruption to patients, physicians and payers. Will they lose payer access if they switch SPs? Then they worry about the time and resources they’d have to invest in changing SPs. So the person leading the manufacturer program will typically endure a lot of pain before admitting it’s not working as planned.
Sometimes, manufacturers simply don’t know there’s a better way. But I assure you there is—and I challenge you to seek it.
Do not allow mediocre to be the status quo. When you choose a truly patient-first approach, everything else falls in line. You’ll have a patient for life, and physician satisfaction will increase because you’re helping them achieve better outcomes.
You’ll also navigate the payer landscape more successfully because payers will see the value in your patient-first model. And as the manufacturer, you’ll see either consistent or even greater revenue. The key is to take care of the patient, not the product. Do that and success will follow.
Take the first step
Whether you’re a Chief Commercialization Officer, Head of Market Access, Head of Patient Services or Head of Brand, start by having the right conversations with your patient services team and asking the right questions.
First and foremost, are you achieving your forecasted goals? If not, where are you falling short and why? If the issue is your sales effort, are you communicating the right message? But if your SP is the root cause, further define the problem by asking:
- Is the speed to patient uptake on target?
- Are you keeping patients compliant?
- Are patients and their physicians satisfied with the SP?
- If physicians aren’t prescribing your medication, why?
- What in the patient and/or physician experience can be improved?
Engage with your team and ask what they would like to see change—for the benefit of all. For example, if your compliance is at 88% today, what would be the business impact of increasing it to 91%? Or accelerating your patient uptake from 20 days to just 14? Or increasing your patient satisfaction? (At Optime Care, we regularly achieve 98%. Patients tell us, “I can’t believe there’s a program like yours.”)
It’s easy to fall prey to the sunk cost fallacy if you feel you’re too far in with your current SP and there’s no sure way to change now. But I challenge you to think differently. We can show you the way to move forward with confidence. The next step is yours, and we’re here to help you take it.