1st Quarter 2007

Designing Support Programs to Promote Patient Persistence and Continuation of Therapy

By Lillian Steinbock

The hands-on case management provided by reimbursement and benefits-counseling programs can help patients access important therapies and bridge reimbursement gaps so that patients fill their prescriptions when they should and follow prescribed dosing regimens.

Manufacturers should consider implementing programs that not only assist patients in securing access to product initially but that also have a mechanism in place to ensure that patients are able to remain on product. For patients taking therapies for chronic conditions, obstacles can resurface repeatedly. Barriers to patient access and continuation of therapy can include finding a funding source or plan that covers the product, securing prior authorization and recertification, overcoming insurance limitations, and affording co-payments. For Medicare Part D participants, these obstacles can prove to be even more burdensome because several different hurdles can arise for one patient in a short period of time, given that many Medicare beneficiaries fill multiple prescriptions.

Patient reimbursement support programs can be designed to help remove financial and insurance-related barriers to continued persistency. Some design features include these elements:

• One-on-one case management, where program case managers check in with patients or providers at set intervals over the course of the patients' treatment to ensure that patients are still able to access product and that they are filling prescriptions on schedule.
  
• Benefits counseling, where program staff help patients identify insurance plan options that cover a prescribed therapy and check in annually to ensure continued coverage.
  
• Patient assistance programs that incorporate a follow-up function where patients or providers are contacted when refills are not obtained.

Covance has expertise in developing and administering patient support programs that help overcome barriers to patient continuation of therapy. Call us for a consultation today.