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Beyond the Prescription: How Patient Support Programs Help Patients Access and Navigate Care · Amplify: A Podcast Powered by Patient Voice Partners

0:01
SPEAKER_02: Welcome to Amplify, Elevating Patient Voices, a podcast powered by patient voice partners, where real stories spark bold conversations.
0:11
SPEAKER_02: I'm Ursula Mann.
0:12
SPEAKER_00: And I'm Brent Cordy.
0:14
SPEAKER_00: Together, we're talking with patients, caregivers, and the healthcare change makers who are listening and taking action.
0:21
SPEAKER_02: From personal journeys to policy shifts, these are the voices shaping a healthcare system that listens.
0:32
SPEAKER_03: I'm here today with my co-host Christine, and we're going to be having a fascinating conversation about patient support programs in Canada.
0:40
SPEAKER_03: Now, patient support programs really offer people different advantages, including being able to get a medication to manage their disease and their treatment.
0:49
SPEAKER_03: Christine, what are your thoughts on today's show?
0:52
SPEAKER_04: Actually, I'm really looking forward to having this conversation because I hate to say this, but back in the days when I was working for a pharmaceutical company, we were pretty much at the infancy of these patient support programs, but I've come to learn that they've come a very long way since then with a lot of advantages and possibly maybe a little bit of things that need to be improved upon.
1:13
SPEAKER_04: I'm looking forward to getting into that conversation and finding out more of where things are at as things ban today.
1:19
SPEAKER_03: I appreciate that, Christine.
1:21
SPEAKER_03: That's really important.
1:22
SPEAKER_03: And I think that one of the things that keeps coming up is people don't really know how they're set up.
1:28
SPEAKER_03: They are a little bit different in Canada than elsewhere in the world.
1:31
SPEAKER_03: They're actually funded by the manufacturer.
1:34
SPEAKER_03: It often comes up people think they're government funded, but they're actually not.
1:38
SPEAKER_03: So it's funded by a pharmaceutical manufacturer and they offer free services to help patients with access to specialty medications and navigate treatment.
1:48
SPEAKER_03: So I'm going to pause there because I'm not the expert in this session, and our guest really is.
1:53
SPEAKER_03: We are delighted to have Nicole Serena join us today.
1:56
SPEAKER_03: What a change maker in the system, and somebody I've had the privilege of knowing for a while now.
2:00
SPEAKER_03: I want to always enjoy our conversations and I walk away learning something new.
2:04
SPEAKER_03: She is the founder and CEO of PSP Solutions, and they are one of Canada's leading experts in patient support programs.
2:13
SPEAKER_03: She has more than 30 years' experience in the pharmaceutical industry, and she has advised over 40 different companies on this topic, from patient access to patient support program strategy, governance, and operational excellence.
2:26
SPEAKER_03: Nicole, thank you for joining us on today's episode of Amplify.
2:30
SPEAKER_03: Thanks, Ursula.
2:30
SPEAKER_03: Thanks, Christine.
2:31
SPEAKER_03: It's great to be here.
2:32
SPEAKER_03: Nicole, over to you to start with.
2:34
SPEAKER_03: Can you give us a little bit of a lay of the land of patient support programs in Canada?
2:40
SPEAKER_03: What are they?
2:41
SPEAKER_03: Why do they matter?
2:42
SPEAKER_03: And what comes to mind when you first hear the word patient support program?
2:46
SPEAKER_01: Sure, Ursula.
2:47
SPEAKER_01: I think, and I'll focus on Canada if we want to talk about US or anywhere else I can as well.
2:53
SPEAKER_01: In Canada, really the reason why PSPs came about in Canada is there are some healthcare gaps within our system.
3:01
SPEAKER_01: Everyone thinks of Canada as a socialized system where everything is covered.
3:06
SPEAKER_01: And the one area that isn't, as always, is getting your drugs covered, getting your prescriptions.
3:11
SPEAKER_01: Once you leave a hospital, you're responsible for paying for those prescriptions.
3:16
SPEAKER_01: So when someone in Canada is in hospital, it's covered.
3:20
SPEAKER_01: And when you come out, and so you may have public or private insurance.
3:23
SPEAKER_01: Private insurance is when your employer pays, but a lot of the time there may be a difference in how much your insurance covers versus what the cost of that drug is.
3:34
SPEAKER_01: And for some of these high-cost specialty drugs, rare disease, that difference can be thousands of dollars a month.
3:41
SPEAKER_01: And so PSPs have come out to support patients.
3:45
SPEAKER_04: Thank goodness for that, because indeed it could be quite a sticker price shock when they get out of the hospital and see some of the costs of these medicines.
3:52
SPEAKER_03: And to compare to the states, knowing that we work globally as well, and there are different groups that come out to chat with us, what are your thoughts comparing and contrasting the patient support program in the states as to what's a difference that comes to mind?
4:06
SPEAKER_01: A lot of the difference is in the US, they categorize them in two different ways.
4:11
SPEAKER_01: So financial assistance, they more call a patient assistance program.
4:14
SPEAKER_01: And again, that's similar to Canada, where they're bridging a gap of a copay or patients who don't have coverage at all and are cash-paying patients.
4:24
SPEAKER_01: Sometimes they'll use coupons and things like that in the US.
4:28
SPEAKER_01: And then a patient support program, the side where there's some nursing support, reimbursement support, and that, it can be a little different because in the US it's a privatized system.
4:39
SPEAKER_01: So sometimes those services are covered within their physician, or there's some restrictions within the US from a law standpoint where they can't do some of the things we do in Canada.
4:52
SPEAKER_03: I think we're very fortunate in Canada to have this incredible patient support program system that we have.
4:57
SPEAKER_03: I feel like there's a lot of amazing services that are offered to patients.
5:02
SPEAKER_03: Is there anything happening in Europe that you feel Canada could benefit from learning from as well?
5:07
SPEAKER_01: In Europe, a lot of the cost of medications is covered by their social system.
5:12
SPEAKER_01: So the financial side usually isn't the same area.
5:15
SPEAKER_01: It's more there may be nurse education, nursing support if you have an infused drug, or learning how to administer an injection yourself.
5:24
SPEAKER_01: So there's more education type programs in Europe rather than the reimbursement side of things.
5:29
SPEAKER_01: And I think the other area of Europe and even other parts of the world is they use a lot more digital type of programs and learning.
5:37
SPEAKER_01: That's where I think in Canada, from a technology standpoint, we could improve our patient support programs.
5:44
SPEAKER_04: So, Nicole, given that to the people that listen to our podcast come from a variety of backgrounds, some are well educated on patient support programs and some less.
5:54
SPEAKER_04: For those who think, okay, but hold on, we're living in a country where there is a program of health care that is paid by our taxes, and we do have drugs being reimbursed by our healthcare system.
6:07
SPEAKER_04: How do you differentiate here?
6:09
SPEAKER_04: Because yes, it's true that in some cases, if somebody has a job and they have a private payer, an insurance program that helps to cover some of the costs, great.
6:18
SPEAKER_04: There's some people who then can possibly have their drugs fully covered by the public healthcare system.
6:25
SPEAKER_04: And I believe some fall in the cracks between the two.
6:29
SPEAKER_04: But could you elaborate a little bit more just to clarify that point about why patient support programs for reimbursement of drugs in this healthcare system?
6:38
SPEAKER_01: Part of it too is for new drugs.
6:40
SPEAKER_01: Some people may know or not.
6:41
SPEAKER_01: It takes a long time to get a drug covered within Canada.
6:45
SPEAKER_01: It could take up to two years.
6:47
SPEAKER_01: And for patients who are excited and physicians who are excited for these new therapies to wait two years.
6:54
SPEAKER_01: And some people can't wait two years to be on a therapy.
6:57
SPEAKER_01: That is another area that patient support programs cover a great gap within our system, is they'll potentially support that gap until reimbursement comes so that patients and their prescribers have the opportunity to use those treatments before they're fully covered by whether it's a public or private insurer.
7:17
SPEAKER_04: That makes sense because then at that point the drug is approved by Health Canada, but the reimbursement side comes, there's a lag time between the time the drug is approved for use and the time that it might be covered on formularies by our healthcare system.
7:32
SPEAKER_04: So thanks for clarifying that point.
7:34
SPEAKER_03: And Nicole raised a really good point, that financial cost.
7:38
SPEAKER_03: If somebody's on clinical trial, perhaps, they're doing well, they wouldn't necessarily get to continue unless they were paying for it.
7:46
SPEAKER_03: And that might be a situation where there could be a lot of discontinuations.
7:49
SPEAKER_03: So to have a company step in to offer this as they're navigating the reimbursement process is vital for continuance for patients.
7:57
SPEAKER_03: So, Nicole, thank you for that background on patient support programs.
8:01
SPEAKER_03: It is a complicated and important setup within Canada and beyond.
8:05
SPEAKER_03: Taking a step back and thinking about you, I'm interested how you started this career journey into this area.
8:12
SPEAKER_03: What drew you into healthcare and how did you end up working in this patient support program?
8:16
SPEAKER_01: Yeah, and I've been in the industry, as we said, for quite a while.
8:19
SPEAKER_01: And I started way back, I actually started working in a pharmacy as my first role.
8:24
SPEAKER_01: So patient-facing, and then started in the clinical trial side of pharma on oncology.
8:30
SPEAKER_01: So at the very beginning, in clinical trials, then went to the commercial side, the whole sales marketing.
8:36
SPEAKER_01: I was a trade manager.
8:38
SPEAKER_01: And while I was in the sales side, I worked at Bayer and I worked in their biologicals division.
8:44
SPEAKER_01: This was many years ago before we really heard a lot about rare disease.
8:48
SPEAKER_01: And in the biological, I worked a lot in the factor replacement area, which is for hemophilia patients.
8:55
SPEAKER_01: So I got to know that community very well.
8:58
SPEAKER_01: And it was probably the first time in my pharmacere where I got to see the face of the patient, their struggles, and how impactful these products were to their life.
9:09
SPEAKER_01: And they were on it forever.
9:10
SPEAKER_01: And it really impacted their quality of life, their length of life.
9:15
SPEAKER_01: But at the same time, there's hurdles.
9:17
SPEAKER_01: They had to learn how to self-inject at home or self-infuse, also get access to the product.
9:23
SPEAKER_01: And so that was where I think built my passion for patients and ensuring that one, they learned how to use their medication, but they also had access to it.
9:34
SPEAKER_01: And from there, I had the opportunity to lead the patient support programs at Bayer.
9:40
SPEAKER_01: And while I was there, I saw a gap.
9:43
SPEAKER_01: There was no one there to help me train my staff, train myself.
9:47
SPEAKER_01: I learned trial by fire.
9:49
SPEAKER_01: It was a complicated area.
9:51
SPEAKER_01: You have huge budgets, a lot of responsibility.
9:54
SPEAKER_01: And there were no consultants who could help you strategically plan, manage issues and everything.
10:00
SPEAKER_01: So about eight years ago, we have a family consulting business, Waldron and Associates.
10:07
SPEAKER_01: I left there and started the PSP solutions arm of our company because I wanted to see PSPs and their teams do better.
10:17
SPEAKER_01: And so that's when I left and started this company.
10:20
SPEAKER_01: That's really interesting.
10:22
SPEAKER_03: That was a defining moment for you that you found this area that you really built your passion around, patients doing better.
10:30
SPEAKER_04: And it makes sense if you started off as a pharmacist and you had that interface with the patient, you saw their struggles probably firsthand right from the beginning.
10:38
SPEAKER_01: Yeah, actually, I was a pharmacy technician.
10:40
SPEAKER_01: So I didn't finish pharmacy school.
10:42
SPEAKER_01: I have a science degree, worked in pharmacy, and it was a long time ago.
10:46
SPEAKER_01: But that's where you first saw the patients.
10:49
SPEAKER_01: True.
10:49
SPEAKER_04: But you were still interfacing with that patient right up front, whether you're a pharmacist or a technician, it's like tomato.
10:55
SPEAKER_03: Yeah.
10:56
SPEAKER_03: And interfacing with those patients and thinking through the years, Nicole, would you say your perspective on patient and patient care has changed throughout your career as you think of these different experiences?
11:08
SPEAKER_03: What do you feel has become bubbled to the top as most important now?
11:12
SPEAKER_01: I think what's most important is that every person is an individual.
11:17
SPEAKER_01: And what I've seen, especially at the beginning when we created PSPs, we had a cookie-cutter approach where everyone was treated like you go through, and we assumed everyone had the same.
11:27
SPEAKER_01: What I've learned is everybody has different challenges.
11:30
SPEAKER_01: And I think the real challenge for PSPs is how do we give someone an individualized approach, yet at the same time make it manageable from a governance and compliance standpoint, managing patient privacy and everything, yet helping that person because every person is their own project manager of their life and their disease journey.
11:52
SPEAKER_01: And PSPs, I see, can help them reduce that burden of all managing all these different things that they're going through.
12:00
SPEAKER_01: I love that.
12:01
SPEAKER_04: Yeah, because some people have a caregiver that can help them navigate a bunch of things, but not everybody has the benefit of that.
12:08
SPEAKER_04: Some people are flying solo and having somebody in their court helping them navigate various aspects of their care, I'm sure, is very helpful to them.
12:18
SPEAKER_01: Exactly.
12:18
SPEAKER_01: And too, the other thing is their caregiver, while they may want to support them, they may not have a lot of experience in the healthcare system and know.
12:27
SPEAKER_01: And so then there can be a lot of frustration or feeling of helplessness.
12:31
SPEAKER_01: And that's where these programs, as well as, of course, their physicians and nurses that support them, can give them that experience to help them through and make them feel supported.
12:41
SPEAKER_03: Absolutely.
12:42
SPEAKER_03: And Nicole, you've seen a number of patient support programs over the years.
12:46
SPEAKER_03: What do you feel separates a great one from one that simply exists or could be doing better?
12:51
SPEAKER_03: What does great look like?
12:53
SPEAKER_01: I think great looks like is they meet the patient where they're at and they can help them identify like this patient needs more support, where another patient may need light support.
13:03
SPEAKER_01: What I see is the best programs when really look at the patient as an individual and have the flexibilities to support that patient rather than just put them through a process.
13:14
SPEAKER_01: So the good ones, there's a process and you go through step one, two, and three.
13:19
SPEAKER_01: The great ones can do that individualized support for the patient to really help them one feel supported in their journey, but two not felt like they have to fit a square thing into a round circle.
13:32
SPEAKER_03: I appreciate that.
13:34
SPEAKER_03: I have not seen within the ecosystem very much information that necessarily compares patient support programs from the standpoint of patient view.
13:45
SPEAKER_03: And I find that really interesting because in most cases, if a patient is on a medication, and I can use biologics as an example, but if they're on a medication, they're on that manufacturer's program, which means that if they're making a change, they're switching locations, they're switching staff, they're going to have a different experience.
14:03
SPEAKER_03: There are more limited patient support programs across Canada that can actually support numerous products.
14:10
SPEAKER_03: Can you tell us a little bit about that difference that you see and what that means for patients?
14:15
SPEAKER_01: Yeah, and part of the challenge too is in Canada, pharmaceutical companies can't actually go direct to a patient.
14:22
SPEAKER_01: So part of the reason there's that lack of knowledge direct to patient is they get all their information from the healthcare practitioner.
14:30
SPEAKER_01: I think what you're talking about is an agnostic PSP has multiple products within it.
14:35
SPEAKER_01: And they're not a lot really available like that.
14:39
SPEAKER_01: There are some oncology programs that have that.
14:41
SPEAKER_01: The ones that have multiple products usually is a company has a lot of products and they have them all in the PSP together.
14:48
SPEAKER_01: So that's, I'd say one of the limitations we have right now is every product has its own PSP or every company has its own PSP.
14:56
SPEAKER_01: So to your point, in biologics, let's say in immunology or dermatology, a dermatologist may have 10 different drugs by 10 different companies, and everyone has a separate PSP, which can be difficult for patients going one to other, like you say.
15:12
SPEAKER_01: And two, there's a lot of complexity there.
15:15
SPEAKER_01: So everyone talks about the idealistic agnostic PSP, which means that all PSPs for, say, dermatology would be in one.
15:24
SPEAKER_01: We're not there yet.
15:25
SPEAKER_01: I think oncology, so in cancer treatments, that would be a natural area where it would be best if we had one.
15:33
SPEAKER_01: Because as a patient progresses through their disease, you may need to be on different products.
15:38
SPEAKER_01: And it would be so much easier for a patient if they could stay in one program.
15:43
SPEAKER_01: But right now, unfortunately, that's not what we have here.
15:47
SPEAKER_04: And you bring up a good point, which is that in Canada, we can't go direct to the patient groups, right?
15:52
SPEAKER_04: So we need to interface through the healthcare professionals, whether it be the physician, nurses, or whoever else is involved in these patient support programs.
16:01
SPEAKER_04: So Ursula and I were just recently at a conference where somebody presented on that and they did a large survey and of the healthcare professionals.
16:10
SPEAKER_04: And from their viewpoint, the issue is that it's placing an additional task on their plate, right?
16:17
SPEAKER_04: Because they have to be that gatekeeper, that interface to the patient.
16:21
SPEAKER_04: And so some of the limitations there are that at a time where they are stretched, and we all know we hear this and read about it all the time in the news, they're being asked to do this extra step because it can't be taken on by the manufacturer directly with the patient.
16:35
SPEAKER_04: It has to go through that group of individuals that are stretched.
16:39
SPEAKER_04: Do you see an end to that?
16:40
SPEAKER_04: Or is there a possibility to remove that burden on healthcare professionals within the Canadian sort of regulatory environment?
16:47
SPEAKER_01: I think there'd need to be a change at the Health Canada standpoint.
16:51
SPEAKER_01: They would have to almost say that patient support is not an advertisement for a product in order for that change.
16:57
SPEAKER_01: I don't think anyone's actually gone to Health Canada to ask for that type of thing.
17:02
SPEAKER_01: And it may be if the physician side showed the value of it, you would really have to, from some kind of governance standpoint, really prove to Health Canada it's not promoting the drug.
17:13
SPEAKER_01: And part of that actually is once you do a prescription, so they've made the decision on the therapy, then a PSP is introduced right to the patient.
17:23
SPEAKER_01: And so I think that would be the thing.
17:25
SPEAKER_01: But right now, because there's no direct-to-consumer promotion to patients, yeah, it's a shame.
17:33
SPEAKER_04: It's a shame that Health Canada sees it that way.
17:36
SPEAKER_04: So right now I don't think so.
17:37
SPEAKER_04: Because you're right, the physician is the one to make the decision as to which product is going to be used.
17:43
SPEAKER_04: So of course, with consultation with the patient, they might say, here's a pro and con of each drug, which one would you prefer, etc.
17:50
SPEAKER_04: Okay, both patient and physician have made a decision.
17:53
SPEAKER_04: And then you introduce the patient support program.
17:56
SPEAKER_04: At that point, there could be hands off.
17:59
SPEAKER_04: It's like, okay, patient and healthcare professional have made the decision.
18:02
SPEAKER_04: Now we just pass it on to the manufacturer to help them navigate the reimbursement or whatever else.
18:08
SPEAKER_04: And that way it would relieve that burden on healthcare professionals.
18:12
SPEAKER_04: It's unfortunate that they see it as a promotional activity.
18:15
SPEAKER_01: Great.
18:15
SPEAKER_01: And actually, here's the difference between the US and Canada, going back to earlier in our conversation.
18:21
SPEAKER_01: In the US, they are allowed to do direct to consumers.
18:24
SPEAKER_01: So in the United States, they can promote a patient support program direct to a patient, which is one difference between the US and Canada.
18:33
SPEAKER_01: So sometimes a patient may see something in the US about a program, and then they'll come back to Canada and ask about it.
18:41
SPEAKER_04: Yes.
18:42
SPEAKER_01: Same with the product itself, right?
18:44
SPEAKER_01: Exactly.
18:45
SPEAKER_01: Yeah.
18:46
SPEAKER_04: Same happens there.
18:47
SPEAKER_03: Nicole, where do you think is the biggest opportunity for patient support programs to still evolve?
18:53
SPEAKER_03: What do you think is coming up around the corner?
18:56
SPEAKER_01: The hot topic right now everywhere is artificial intelligence and how do we use it.
19:01
SPEAKER_01: And I think the best part, there's a lot of manual processes still within PSPs, more on the back, what I call the backstage.
19:09
SPEAKER_01: So I think if we use technology in the back in a lot of the processes, there could also be with you can do some predictive analytics on reimbursement and that sort of thing that may speed up and also help patients.
19:23
SPEAKER_01: I think the area that everyone's focusing is on communicating with patients.
19:27
SPEAKER_01: And I really think the human needs to stay.
19:30
SPEAKER_01: So human-to-human conversation for patients is still very important.
19:35
SPEAKER_01: Not everyone wants to talk to a chatbot.
19:37
SPEAKER_01: So I think we need to really think about where we use AI, but I think that will one help because sustainability of programs, these are very expensive programs to run from the pharma side.
19:49
SPEAKER_01: Sustainability is a big conversation.
19:52
SPEAKER_01: So in order to continue supporting patients with these programs, I think we do need to use technology to manage some of the manual part of it so we can continue to support patients, yet not take away that personalization.
20:07
SPEAKER_01: That's, I think, the balance that we need to see in the future of PSP.
20:11
SPEAKER_01: The part that we want to make sure with AI is not to take away the human factor by using chatbots and communication and the introduction of PSPs using technology.
20:22
SPEAKER_01: We want to keep patients having that conversation and feeling like they're still individual.
20:28
SPEAKER_01: Yet we can use technology, especially on a lot of the manual processes.
20:33
SPEAKER_04: More on the logistical side of things, if I understand correctly, but not so much on the patient interface and discussion that would be with a live person.
20:42
SPEAKER_04: That makes sense.
20:43
SPEAKER_04: Exactly.
20:44
SPEAKER_03: And that is such a thoughtful approach because there was a project where there were human factors or humans that were replaced with technology.
20:53
SPEAKER_03: And what the company realized late is that what the patients liked best about the program were the humans that they were interacting with.
21:01
SPEAKER_03: So they had to take a few steps back and revamp things.
21:04
SPEAKER_03: I love that you're thinking proactively as to where to have efficiencies and use technology, but make sure we're maintaining that person-to-person touch point.
21:13
SPEAKER_03: I think that's really thoughtful.
21:15
SPEAKER_03: You're also really passionate about health literacy and patients ensuring that they're asking the right questions and they're helping guide their care.
21:24
SPEAKER_03: Tell us a little bit more about that.
21:26
SPEAKER_01: I think that's another area that patient support programs can do better at too, is not everyone showing up to a PSP has the same knowledge of our healthcare system, even their education, their language.
21:38
SPEAKER_01: So really ensuring patients one understand the program and the support they can get.
21:44
SPEAKER_01: Two, if we think of consent, the consent that they're giving.
21:47
SPEAKER_01: A lot of the time I think people may not fully understand and they're afraid if they ask questions, they won't be able to participate in the program.
21:56
SPEAKER_01: My recommendation is ask as many questions as you can.
22:00
SPEAKER_01: Sometimes when you're in your physician's office, you have a very short time and they tell you a lot of information and you might not get it.
22:06
SPEAKER_01: You can ask additional questions about the medication, the therapy.
22:11
SPEAKER_01: That case manager or nurse case manager on the phone can take an hour of time with you potentially to answer all your questions.
22:19
SPEAKER_01: So don't be afraid to ask lots of questions.
22:22
SPEAKER_01: If you don't understand a term like what financial assistance is, or if you have to go for an infusion, or you want to understand more about potential side effects, these are the people who can give you a lot more information and take the time.
22:37
SPEAKER_01: So really don't be afraid that if you ask the wrong question, you're going to get denied being in a patient support program.
22:44
SPEAKER_01: They're really there to support patients.
22:46
SPEAKER_01: Ask all the questions.
22:48
SPEAKER_04: Because are there really any questions that somebody could ask that would actually deny them?
22:52
SPEAKER_04: I find that interesting that people would be afraid to ask certain questions for fear of being denied the patient support program.
22:59
SPEAKER_01: And also we think of Canadians, we don't like to talk about if we can't afford something or anything like that.
23:05
SPEAKER_01: And they may not realize that these programs are here to help you with financial gaps, with knowledge gaps, all of it.
23:12
SPEAKER_01: And so just sometimes I think we're overwhelmed and sometimes afraid to ask a question.
23:18
SPEAKER_01: I've heard it where patients are worried if they say the wrong thing, they'll get kicked out of a program.
23:23
SPEAKER_01: That's very unusual to happen.
23:25
SPEAKER_01: Really, the only time something like that may happen is if you're prescribed something and it wasn't too exactly the product monograph indications, then you may get referred to a medical department to get supporting care.
23:39
SPEAKER_01: I think that's really thoughtful.
23:40
SPEAKER_03: I have heard of that fear where people are worried and we need feedback from people as to how things are going.
23:46
SPEAKER_03: And there can be a lot of learnings across programs.
23:49
SPEAKER_03: What would make this better?
23:50
SPEAKER_03: What would make this more seamless?
23:52
SPEAKER_03: But we need to do that in the right way.
23:54
SPEAKER_03: And so to put patients in situations where the person providing the program or the provider is asking the code, that can be really tricky because the person sitting there going, well, if I honestly say what would make it better, am I going to get kicked out?
24:07
SPEAKER_03: So your advice for patients, Nicole, is don't be afraid to ask questions.
24:11
SPEAKER_03: These programs are really there to help you.
24:13
SPEAKER_03: You can ask a lot to learn, like with that information that the physician gave you, it's a lot all at once.
24:18
SPEAKER_03: So I appreciate that on the patient front.
24:21
SPEAKER_03: What about for healthcare leaders?
24:23
SPEAKER_03: For those listening today, what would you advise them?
24:25
SPEAKER_03: What's an action they can take tomorrow to improve the patient experience?
24:29
SPEAKER_03: What would you want to see them do?
24:32
SPEAKER_01: I think one thing in patient support programs that a healthcare leader could do is actually to what you just said, get more patient feedback.
24:40
SPEAKER_01: Find out what the experience is happening in the program.
24:43
SPEAKER_01: I'd also say a lot of the time we start a patient support program and you just let it run without really checking in to say, what are the services that patients most use?
24:54
SPEAKER_01: And are there things that you're paying for that actually no one's using?
24:57
SPEAKER_01: And to redirect those funds into areas that need more support.
25:02
SPEAKER_01: But truly check in and find out how is the program going.
25:05
SPEAKER_01: I think that's part where healthcare leaders, we set it running and then you just assume it's going well rather.
25:11
SPEAKER_01: And the only time you hear anything about it is when something goes wrong rather than getting that continuous feedback.
25:18
SPEAKER_01: And sadly, a lot of the time, the only time senior leaders hear about a PSP, if there's an issue, and then they assume, oh, it's not working, we don't get the positive feedback from patients either of how much they're helping them as well.
25:31
SPEAKER_04: So just to be clear, Nicole, what you're mentioning in terms of health leaders is the manufacturer's health leaders, not the healthcare professionals.
25:39
SPEAKER_04: It's not up to them to get the feedback, anyways, from their patients.
25:43
SPEAKER_01: Yeah.
25:43
SPEAKER_04: They tend to get the feedback and never hear it.
25:46
SPEAKER_04: Yeah, exactly.
25:47
SPEAKER_04: But the manufacturers themselves who put so much of an investment behind patient support programs, it would be worthwhile to check in with their client base, because there is a way to do that within regulation and so on, to get that feedback and be able to make those tweaks wherever necessary.
26:05
SPEAKER_01: So to answer the question on the other side, for healthcare leaders, physicians, even in public and private leadership, I think one is to learn more about patient support programs, ask questions about them, but also let them know where they're working and where they're not working.
26:23
SPEAKER_01: One thing that I saw a few years ago was, especially in the oncology, there's drug access navigators, there's oncology clinic nurses in the hospitals, there was some duplication of areas of work.
26:35
SPEAKER_01: And so there was a lot of work starting to be done because there's pushback saying we already educate patients, we already do this.
26:42
SPEAKER_01: Why are we duplicating what's in a PSP?
26:45
SPEAKER_01: And so we saw in that therapeutic area with a quite a few of the programs is that they worked together with healthcare leaders to ensure that there wasn't a duplication of service, but rather supporting the gaps in the area and really doing what PSPs do well and letting the clinics do their part.
27:05
SPEAKER_04: True.
27:06
SPEAKER_04: But on the other hand, when you're dealing with a very complicated health issue, there is something to be said about repetition.
27:12
SPEAKER_04: In my experience with people that are in end-stage chronic kidney disease or end-stage kidney failure, they get bombarded with so much information that the nurse and the doctor might have told them multiple times and yet it still hasn't sunken in.
27:28
SPEAKER_04: And so to have yet another person reinforce that same message is not necessarily wasted.
27:33
SPEAKER_04: But I agree with you.
27:34
SPEAKER_04: I mean, because it's so labor-intensive, all of this, if you can fill a gap that's not currently met, that should take priority over that duplication for sure.
27:44
SPEAKER_01: And I think to your point, ensuring it's the same message.
27:48
SPEAKER_01: So to ensure that everyone's saying the same thing rather than there's a difference in what they were saying.
27:55
SPEAKER_01: Absolutely.
27:56
SPEAKER_04: For sure.
27:57
SPEAKER_03: And you highlighted big budgets earlier.
28:00
SPEAKER_03: These are big budgets that go into this, but I can see what you mean, and that's what I have seen as well.
28:06
SPEAKER_03: People get busy just running their patient support program to take pause and think thoughtfully, because these are big dollars to operate this around what's going well and what could be different sometimes gets missed.
28:17
SPEAKER_03: So I really appreciate you flagging some things that people can think about in terms of what to do differently around moving forward and other things that they could make even better that in some ways could have them save dollars to repurpose to other areas that are more meaningful for patients and carriers.
28:33
SPEAKER_03: I think that's really thoughtful.
28:35
SPEAKER_03: Is there anything else about patient support programs that we haven't chatted about today that you think is really important?
28:40
SPEAKER_01: I think we've chatted a lot about it.
28:42
SPEAKER_01: I think one of the other areas that we're seeing is in rare disease and ultra-rare, and even some of the new gene therapy, and you may hear also CAR T therapy.
28:53
SPEAKER_01: There's some different types of services that are supported there because patients have to travel.
28:59
SPEAKER_01: And so the interesting thing about PSPs as new therapies come out is you're strategic looking at where the patient access gap is.
29:07
SPEAKER_01: So traditionally it was financial or learning how to administer or going somewhere to get it administered.
29:15
SPEAKER_01: Now it could be that I need to be away from my house to get my therapy for three or six weeks.
29:22
SPEAKER_01: And so that travel could be the access gap because I have to travel.
29:27
SPEAKER_01: If we think a lot of patients in Canada live in rural areas, they need to travel hours away.
29:33
SPEAKER_01: Or in some provinces, there's only one treatment center.
29:36
SPEAKER_01: So sometimes PSPs help they don't pay for travel or anything, but they help patients manage where they could stay, how they could get there, that sort of thing.
29:46
SPEAKER_03: Yeah, that makes sense.
29:48
SPEAKER_03: That's really thoughtful for navigation and good it's been flagged as an area to develop because to manage all of that, where to stay on top of not feeling well is overwhelming.
29:58
SPEAKER_03: Those are huge logistical details that need to be taken care of.
30:02
SPEAKER_03: So to make that more seamless and have that taken off the to-do plate is very thoughtful.
30:06
SPEAKER_03: This has been fascinating on patient support programs.
30:10
SPEAKER_03: Nicole, thank you for your leadership in this area.
30:12
SPEAKER_03: As I said, it's lovely bouncing into you in the space.
30:16
SPEAKER_03: And I always learned something new about this complicated setup.
30:19
SPEAKER_03: In addition to your work as CEO at Patient Support Solutions, and you founded it as well, you've moved on to do a lot of writing.
30:30
SPEAKER_03: And tell us a little bit about the books that you've written and what made you start.
30:35
SPEAKER_01: The first book I wrote actually was while I was leaving corporate, is I hired a lot of interns.
30:42
SPEAKER_01: And what I see is new people just getting out of school and trying to get into a career and getting a job.
30:48
SPEAKER_01: And we probably all remember it.
30:50
SPEAKER_01: Everyone wants you to have experience, yet you need the opportunity to have the experience.
30:55
SPEAKER_01: So we'd bring interns into a corporate area and give them some menial tasks.
31:00
SPEAKER_01: So when they were going for an interview, they didn't have a lot to explain.
31:04
SPEAKER_01: So my interns, I give them real projects.
31:07
SPEAKER_01: So my first couple of books were talking about how, as corporate, we can design internship programs to give them real work.
31:14
SPEAKER_01: So when they are trying to get a job and in an interview, they can actually talk about some work experience that was impactful.
31:22
SPEAKER_01: And then my next book after, and I did it with Daniel, my business partner, was about the intern said to me, How do we get these interns?
31:30
SPEAKER_01: So then we wrote a book for them on how to get an internship.
31:33
SPEAKER_01: And then from there, just different areas I've done.
31:36
SPEAKER_01: I wrote a book on mentoring because it's an area that I think I had a lot of great mentors.
31:42
SPEAKER_01: I mentor people.
31:43
SPEAKER_01: So again, there's a way to do mentorship so it works for both people, the mentee and the mentor.
31:49
SPEAKER_01: It's a two-way street.
31:50
SPEAKER_01: It's not just one person giving all their knowledge, it's a relationship.
31:55
SPEAKER_01: And then just recently we published a new book on pharma and AI because everyone's talking about it.
32:01
SPEAKER_01: So it's really looking at how do we strategically look at processes and look at strategy first, not just throw AI on everything, but really look at from a strategy session.
32:12
SPEAKER_01: Yeah, those have been a few.
32:13
SPEAKER_01: And then I wrote a fun book with my sister.
32:15
SPEAKER_01: That's a kid's book, right?
32:16
SPEAKER_01: She's an artist.
32:17
SPEAKER_01: So we had fun writing a kid's book too.
32:20
SPEAKER_01: That's just my passion that I do on top of all the corporate stuff.
32:24
SPEAKER_04: I don't know how you manage to expand a 24-hour day into something that is how do you fit all this into 24 hours a day?
32:32
SPEAKER_04: Multi-dimensional, right?
32:34
SPEAKER_03: That's my next source of advice from Nicole.
32:37
SPEAKER_03: Yes.
32:37
SPEAKER_03: If you're working on a cloning project, I want to hear about it as well.
32:40
SPEAKER_03: So, how many books are there and where are they available?
32:44
SPEAKER_03: Where can people access these?
32:45
SPEAKER_01: So, all my books are on Amazon.
32:47
SPEAKER_01: I think there's about seven or eight.
32:49
SPEAKER_01: I wrote a couple of interesting journals too.
32:52
SPEAKER_01: I do a lot of journaling in the morning time and have some processes.
32:56
SPEAKER_01: So I wrote a couple journals as well that came out in the last year as well.
33:00
SPEAKER_01: Amazing.
33:01
SPEAKER_01: Congratulations.
33:02
SPEAKER_01: Thank you.
33:03
SPEAKER_03: That's fantastic, Nicole.
33:05
SPEAKER_03: Love that you are doing that.
33:06
SPEAKER_03: And it almost sounds like it's a little bit of a way for you to unwind.
33:10
SPEAKER_03: What is the greatest source of joy that you get as a writer and an author?
33:14
SPEAKER_03: What have you found?
33:15
SPEAKER_01: Oh, I get a lot, as you can imagine, my brain's pretty busy.
33:18
SPEAKER_01: So I call it downloads.
33:20
SPEAKER_01: So I'll get an idea and I just download and I write.
33:23
SPEAKER_01: And so a lot of these books, and they're not long books, but I tend to write books that are about a hundred pages or so.
33:29
SPEAKER_01: So they're easy to read and just concepts that have had value for me.
33:34
SPEAKER_01: And I want to share them with everybody else.
33:37
SPEAKER_04: Fantastic.
33:38
SPEAKER_04: I love that.
33:39
SPEAKER_04: So when you do have a spare moment, and maybe if you take the time to have a vacation.
33:46
SPEAKER_04: We just heard that you've been to Hawaii recently, and it sounds like there was a little story to tell on that one.
33:51
SPEAKER_04: Do you want to share?
33:53
SPEAKER_01: Yeah, sure.
33:53
SPEAKER_01: So I was in Hawaii, and while I was there, another passion of mine is martial arts.
33:58
SPEAKER_01: So I've done martial arts for 30 years.
34:00
SPEAKER_01: So I was actually in a martial arts retreat.
34:02
SPEAKER_01: So one, most people that know me, they're like, You actually went on vacation and didn't work.
34:06
SPEAKER_01: I'm like, yeah, mostly didn't work.
34:08
SPEAKER_01: And but I did martial arts.
34:10
SPEAKER_01: It was fun.
34:10
SPEAKER_01: We did Tai Chi on the beach.
34:13
SPEAKER_01: We did Kung Fu in the park.
34:15
SPEAKER_01: I'm learning also straight swords.
34:17
SPEAKER_01: So we do straight sword tai chi, which is fun as well.
34:20
SPEAKER_01: So yeah, that's a passion of mine.
34:23
SPEAKER_01: And in the last year or so, I've been able to reignite it.
34:26
SPEAKER_01: I did it a lot in my younger years.
34:28
SPEAKER_01: Now I'm doing it now too.
34:30
SPEAKER_01: That's amazing.
34:32
SPEAKER_01: Nice.
34:32
SPEAKER_01: On which island did you do all this?
34:34
SPEAKER_01: I was on the small island, Kauai, near Princeville.
34:37
SPEAKER_01: Oh, I love Kauai.
34:39
SPEAKER_01: And the weather was beautiful too.
34:41
SPEAKER_01: So can't complain about that as well.
34:43
SPEAKER_01: Isn't it always there?
34:45
SPEAKER_01: I think so.
34:46
SPEAKER_01: Yes.
34:46
SPEAKER_01: That's amazing.
34:47
SPEAKER_03: I'm glad you got a way to recharge, enjoy, and reinvigorate in a different way.
34:51
SPEAKER_03: And want to say thank you for joining us today on Amplifying this fantastic conversation on patient support programs and the leadership that you're sharing and doing in this space, Nicole.
35:01
SPEAKER_01: Thanks for having me, Ursula.
35:02
SPEAKER_01: Thank you so much.
35:03
SPEAKER_01: It was wonderful meeting you.
35:05
SPEAKER_01: Thanks, Christine.
35:10
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35:44
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35:54
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35:56
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