For diabetic patients visiting physicians in BIRDEM hospital, there is a special corner. Patients prescribed insulin for the first time would be advised to go there. Administration of this drug may be tricky. That is why they are referred to that section, where qualified trainers teach them how to take insulin and answer other questions about the drug’s preservation, administration, and adverse effects.
In short, this is what a patient support program (PSP) does. However, the scope of a PSP is broader, and educational activities are only a part of it. The objective of a PSP is to ease access to medication and support them to maintain adherence to the prescribed treatment. This is particularly useful for patients with complex and chronic diseases, e.g., cancer, neurological disease, cardiac conditions, rheumatological disorder, etc. These patients often require lifetime treatment, thus imposing huge monetary and psychological burdens on the patients and caregivers. They need support to help them continue the therapy.
Pharmaceutical companies or healthcare providers can design PSPs. They are thought to be critical for a better patient outcome. They can help improve the standard of care and quality of life. For Pharma companies, that may also translate to retention of patients on the prescribed medicine and opportunities for more penetration into the target customers. PSPs can enroll patients who have never had a particular medicine and help keep them on it if the benefits outweigh the risks.
There are many varieties of PSPs worldwide. Some focus on educating patients on the disease and drug, and some provide financial assistance by subsidizing costs; some offer special support to administer the medicine, and others may offer a comprehensive approach throughout the entire life cycle of the therapy. They are important for the healthcare industry to increase access to medicine, improve the chances of treatment success, and act as a source of real-world data that can be leveraged for the betterment of care.
A patient’s journey through the PSP starts after a diagnosis is made and the physician decides on a treatment plan. If there is a PSP for that treatment, and the patient meets the eligibility criteria, then the physician can inform them about the available support. If the patient agrees, the physician is usually the one who enrolls them in the program.
In the next step, the program staff communicates with the patient and collects the necessary information to set them up with the offered services. There is a follow-up system to make sure patients are complying with treatment. There is coordination among the patient, PSP, and the physician to make sure there is no issue with the quality of care. It must be stressed that the program staff only proceeds when the patient provides explicit consent. The consent can be withdrawn anytime, and the patient can leave the PSP as they please.
What kind of services can PSP offer? One of the commonest is cost rebate or discount. There are a lot of drugs, especially for chronic diseases, that are prohibitively expensive. These are usually drugs with existing patents. There are low-cost generics in countries like Bangladesh, where patent law is not applicable. However, physicians may prefer the safety and effectiveness of a research-based original molecule if there is a way to make it affordable for the patients.
Another aspect of the PSP is education. Just like insulin administration training, patients can be educated about the disease, which improves the likelihood of adherence. This is something that the PSPs can separately reinforce by offering regular checks by nurses or pharmacists through phone or email.
Physicians usually view PSPs as complementary to their service. Patient adherence is critical to success but is not discussed in detail during routine consultations due to time constraints. So, if a PSP works on adherence, physicians can refer the patients there. Also, if the cost of the drug is too high, but the physician feels it is the only option, they can certainly use the support of PSPs.
According to Christina Jackson, behavioral psychologist of an international organization, Sprout Health Solutions, when developed with proper expertise and specific focus, PSPs can reduce workloads for the health care providers (HCPs) by addressing challenges that do not generally fall under the purview of regular consultation. Such PSPs can positively include patients in their own treatment and help reduce the frequency of hospital and clinic visits.
Based on research by Iqvia Consulting, PSPs can make a real positive change in the treatment. Their data showed that after spending one year in a PSP, the adherence rate was better for 90% of the patients, and 61% had a better outcome than non-enrolled patients. Deloitte also analyzed similar data and concluded that PSPs can empower patients and foster better relationships with their physicians.
The scope of PSP has broadened. Even a decade ago, their main goal was to reduce the cost to increase access. But they have evolved, and nowadays, many programs are concerned with overall care, not only the financial aspect. There is a push towards a holistic approach, where an enrolled patient can get all required services from one platform. Such an approach aims to maximize the number of patients receiving the right drug and mitigate barriers that prevent or delay such receipt. With technological advances, including AI, we can see a future where integrated care would be possible.
Aaron Hall, Associate Creative Director from the international marketing agency Purple Agency, highlighted the changes technology can bring. According to him, technology changed how HCPs and patients interact and created more opportunities to gather and analyze data from the field.
The main challenge of PSP is that many patients are unaware of it. According to FierceHealthcare, pharmaceutical manufacturers spend about 5 billion dollars yearly on PSP, but only 3% are enrolled. They surveyed 5,000 people. Only 23% knew PSPs existed. Even if the patients know about the PSPs, many are unaware of how they can benefit. Of the 23% who knew of PSPs, 55% learned about it from a physician, and 10% found it online.
PSPs can do a lot of good. So, patients must be engaged more meaningfully so the information is available to more and more of them. This may require a coordinated effort among the PSP provider, HCPs, and probably patient advocacy groups.
Pharma companies should look to partner with pharmacies with materials on-site or to get pharmacists to engage. Another suggestion is building omnichannel patient support programs that can reach the correct, targeted audience where they are spending time online already.
There are concerns, definitely, especially in terms of data privacy. That is a challenge not only for PSPs but for any business nowadays. PSPs collect sensitive patient data, so they must employ stringent safeguards to protect it. Based on their geographical territory, they also need to fulfill government regulations.
In the end, it can be said with confidence that with proper structure and expertise, a PSP is a great tool for patients to increase the likelihood of a positive outcome. Not only that, PSPs can help them feel involved in the decision-making process. Charlotte Maule, director at healthcare public relations agency Anthem, emphasized that it is the desire for most patients to be an active part of the disease management process. PSPs can empower them to achieve that goal.
Dr. Imtiaz Ahmed is a medical graduate from Dhaka Medical College with over eight years of experience in global pharmaceuticals. He is involved in improving the quality of care for the betterment of the patients.