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that only one out of five patients are aware of hub services.1 Lack of provider and patient awareness as well as outdated communication channels such as phone calls and faxes limit hub engagement.1,2
At CoverMyMeds, a division of McKesson Prescription Technology Solutions, we have developed an electronic solution that sets a new starting point for patient access to specialty therapies through hub integration into our active network. This network includes more than 700,000 providers, payers representing 96% of prescription volume, 96% of pharmacies and over 200 life science brands – allowing us to help nearly 5 million patients per month. Our relationship with RxCrossroads by McKesson, a business within McKesson Life Sciences that offers commercial solutions for biopharma companies, further reinforces our solution through deep specialty expertise and high-touch patient support services.
Through our network connection with providers, enrollment now begins upstream and is funneled through the point of prescribing so that all patients are supported on their journeys, from access to adherence. As a result, potentially five out of five patients prescribed specialty medications can be supported on their journies.
From the moment an e-Prescription is written, patient enrollment into our support services begins electronically through 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% 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 and are automatically enrolled through a preferred1,2 and trusted source, their provider.
This self-service platform is configurable within provider workflows and saves time by auto-populating forms. Through an online dashboard, everyone has visibility into which steps need completed and who is responsible. Patients are supported through their adherence journey with educational materials, automated reminders and help with prescription refills.
Driven by technology, human intervention is now an exception within the specialty workflow – allowing us to capture all patients through a streamlined process to help improve time to therapy, medication adherence and patient outcomes. Always available to handle potential complications, case managers and support specialists from CoverMyMeds and RxCrossroads can step-in for outstanding steps or unique situations.
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.3,4 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.
Before starting treatment, Robin is educated about her specialty therapy – providing her with welcome information during a potentially stressful time. Similar to many patients, ongoing adherence can be a struggle for her as altering dosage, changing insurance coverage and relocation can complicate the process for refilling prescriptions. With CoverMyMeds and RxCrossroads, she is supported through refill reminders, copay offset solutions, as well as clinical and behavioral experts that can help her overcome adherence challenges.
Flipping the Script on Medication Access
On her own, Robin’s journey is difficult. With CoverMyMeds, her story and millions of other patients’ can be different.
To learn more about how CoverMyMeds and RxCrossroads by McKesson are modernizing medication access and adherence, visit go.covermymeds.com/specialty.
*Robin is a persona created to summarize the similarities we heard while interviewing patients.
- 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