Latest / Pharmacy Podcast Network / Turning Data into Action - Exploring Access Analytics and What’s Next for Specialty Pharmacy with Claritas Rx | NASP Specialty Podcast

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Turning Data into Action - Exploring Access Analytics and What’s Next for Specialty Pharmacy with Claritas Rx | NASP Specialty Podcast · Pharmacy Podcast Network

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  Speaker 1: You are listening to the global network of podcasters dedicated
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  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
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  Speaker 2: You're listening to the NASP Specialty Pharmacy Podcast, a collaboration
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  Speaker 2: between the National Association of Specialty Pharmacy and the Pharmacy
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  Speaker 2: Podcast Network. Each episode dives deep into trends, challenges, innovations,
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  Speaker 2: and patient centric practices shaping the future of this dynamic
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  Speaker 2: and rapidly evolving industry. Whether you're a pharmacist or healthcare provider,
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  Speaker 2: patient advocate, or industry leader, you'll hear expert insights, real
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  Speaker 2: world evidence, and thought provoking discussion that highlights all that
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  Speaker 2: makes specialty pharmacy special.
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  Speaker 3: In support of NASP's mission to empower specialty pharmacy stakeholders
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  Speaker 3: to advance the standard of patient care, NASP supports a
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  Speaker 3: free market healthcare system in which all specialty pharmacies compete
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  Speaker 3: on the same fare and level playing field, because that
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  Speaker 3: is in the best interest of the patients.
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  Speaker 4: We collectively serve.
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  Speaker 3: NASP is committed to working with all stakeholders and policymakers
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  Speaker 3: to ensure that all patients have access to the life
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  Speaker 3: saving medications they need and the high touch patient care
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  Speaker 3: and support services they deserve from the pharmacy of their choosing. Hello.
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  Speaker 4: My name is Sheila Arquette, and I'm the President and
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  Speaker 4: CEO of the National Association of Specialty Pharmacy. I am
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  Speaker 4: delighted to welcome my very special guest, Hillary Gretton to
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  Speaker 4: this episode of the NASP podcast. Hillary is a patient
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  Speaker 4: centric commercial leader with extensive experience in healthcare and specialty
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  Speaker 4: pharmaceutical analytics. As Director of Data Strategy at Claritas RX,
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  Speaker 4: she leads the development and execution of advanced analytics initiatives
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  Speaker 4: that align patient needs with commercial objectives. Passionate about innovation,
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  Speaker 4: Hillary empowers companies to streamline patient access to therapy by
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  Speaker 4: leveraging AI, machine learning, and best practices. She holds an
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  Speaker 4: MBA and is a Certified Pricing professional. Today, Hillary will
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  Speaker 4: share how Claritas RX supports manufacturers through their new Access
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  Speaker 4: Analytics product, and insights from one of their recent white papers,
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  Speaker 4: From Prescription to Abandonment our thirty one percent of specialty
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  Speaker 4: medications go unfulfilled across therapeutic areas, highlighting key reasons for
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  Speaker 4: patient abandonment during pharmacy transitions. Let's dig into this paper
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  Speaker 4: and discuss ways these new published insights can help us
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  Speaker 4: better support patients. Hillary, thanks so much for joining me today.
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  Speaker 5: It's lovely to be here with Youshila. Thank you so.
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  Speaker 4: Drawing on your pharmaceutical background and the insights from your
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  Speaker 4: recent white paper research, can you share what you found
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  Speaker 4: and specifically, what I'm thinking is what are the biggest
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  Speaker 4: challenges facing today's market access landscape for specialty products and
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  Speaker 4: how do these obstacles affect the patient journey?
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  Speaker 5: Yeah, so, Sheila, I think that's a really great question
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  Speaker 5: to kick us off on today's conversation. And this is
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  Speaker 5: a multifacet issue for today's pharmaceutical companies and especially when
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  Speaker 5: you look in the specialty the rare orphan disease state
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  Speaker 5: where you have a very small subset of patients that
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  Speaker 5: really need support and timely support. And I think the
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  Speaker 5: heart of all of this is data. There's simply there's
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  Speaker 5: not enough. It's scattered across different platforms, formats, and really
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  Speaker 5: navigating it is complicated by this constantly changing environment that
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  Speaker 5: we're seeing both inside and outside of pharmaceutical companies. You know,
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  Speaker 5: we have new executive orders that are coming out, there's
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  Speaker 5: evolving regulations and then there's this really highly competitive market
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  Speaker 5: that we have with fresh disruptors, new products, indication expansions
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  Speaker 5: coming out all of the time, and trying to keep
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  Speaker 5: your arms around all of us and to say what
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  Speaker 5: is the best way to proceed forward. So you have
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  Speaker 5: pharmaceutical companies that aren't just trying to collect this data,
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  Speaker 5: they're also holding ongoing conversations with specialty pharmacies and their
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  Speaker 5: hub partners and really trying to get this true three
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  Speaker 5: sixty picture of what their patients needs and what the
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  Speaker 5: barriers are that are in the way at this time.
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  Speaker 5: And so when these questions arise about the accuracy of
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  Speaker 5: that data or thinking about when partner realizes that there's
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  Speaker 5: an issue and then they have to restate it, adjust it,
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  Speaker 5: make people aware of it that they're going to be
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  Speaker 5: doing a restatement. This really only deepens the gap between
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  Speaker 5: this real patient activity and then what that pharma company
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  Speaker 5: can actually see internally. So think about it. If a
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  Speaker 5: patient does something on Monday, the file comes in on Tuesday,
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  Speaker 5: that's sent over to the manufacturer on Wednesday, then they
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  Speaker 5: need to do a restatement that might not come through
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  Speaker 5: until Thursday or Friday. That is a full week between
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  Speaker 5: when something has actually happened to a patient and then
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  Speaker 5: the pharmaceutical company being able to see it and potentially
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  Speaker 5: help or mitigate any risk that is actually happening. So
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  Speaker 5: think about that. Every day that's lost in that process
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  Speaker 5: means yet another delay in really delivering effective support along
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  Speaker 5: the patient journey.
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  Speaker 4: Yeah, okay, And what are the kind of things that
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  Speaker 4: you're looking for, like what happened to them on Tuesday?
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  Speaker 4: Like what do you mean?
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  Speaker 5: So I think that's a good question. You know, sometimes
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  Speaker 5: we can look at this and say, is the patient
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  Speaker 5: flowing through the patient journey as we would anticipate, So
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  Speaker 5: kind of going back to that benefit investigation and benefit verification,
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  Speaker 5: we might say I could take half a day or
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  Speaker 5: a day, that's fine. Or if somebody is going through
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  Speaker 5: the affordability portion and they might, you know, think about
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  Speaker 5: what the cost is and how to help mitigate that.
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  Speaker 5: If it's potentially something particularly onerous for them, they might
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  Speaker 5: say okay, that's they can sit in that stage for
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  Speaker 5: about twenty four hours. But I think what we're looking
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  Speaker 5: for as a part of our patient journey analysis is
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  Speaker 5: to be able to say, is someone sitting far too
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  Speaker 5: long in a position? So are they sitting in the
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  Speaker 5: affordability for let's say five days, Well, that's a trigger
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  Speaker 5: that someone needs to go in and help that because
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  Speaker 5: they're stuck, or maybe there's some sort of miscommunication happening,
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  Speaker 5: if any communication is happening. But ultimately I think that's
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  Speaker 5: it is to be able to say by market, basket
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  Speaker 5: or therapeutic area, by brand, by patient segment, is this
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  Speaker 5: patient behaving as we would anticipate, or is somebody kind
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  Speaker 5: of sticking out like a sore thumb. There an outlier
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  Speaker 5: and they might need some help. We might go in
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  Speaker 5: and say, or by we, I mean the manufacturer might
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  Speaker 5: go in and look at that and say, oh, it's okay.
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  Speaker 5: Patient Hillary Gretin is actually just having some difficulty with this,
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  Speaker 5: but she does not need our help. But it also
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  Speaker 5: could be patient Shila is in that for five days
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  Speaker 5: and she really really needs some support because she's actually
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  Speaker 5: behind on product or at risk of not having enough product.
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  Speaker 5: So I think it's just kind of a mixture of
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  Speaker 5: things to say, is this patient appropriately where they should
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  Speaker 5: be given what we would anticipate.
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  Speaker 4: Sure, you can probably aggregate this data too. Right for manufacturers,
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  Speaker 4: and if they have like a new drug launch, say well, hey,
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  Speaker 4: and you know this is where you had pain points
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  Speaker 4: for this drug if it's you know, a similar disease
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  Speaker 4: state or you know patient population or characteristics, and you
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  Speaker 4: may want to make sure that you know, especially pharmacies
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  Speaker 4: know that these assistance programs are available or that this
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  Speaker 4: blood work is going to be needed or right that
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  Speaker 4: these things typically get denied because of X, Y and
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  Speaker 4: Z and kind of be proactive with that.
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  Speaker 5: So Sheila, if I can come back and talk with
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  Speaker 5: you and next time, we actually at claritos RX have
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  Speaker 5: an amazing opportunity with performance benchmarking to be able to
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  Speaker 5: look at how products are performing and to be able
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  Speaker 5: to say what have we seen within certain therapeutic areas,
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  Speaker 5: certain market baskets. Thinking also about product life cycle. So
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  Speaker 5: I loved how you brought that in right, what is normal,
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  Speaker 5: what is good? And what does good look like? And
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  Speaker 5: that allows people to create an analog or scaffolding to
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  Speaker 5: say where am I in my product life cycle? Did
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  Speaker 5: I just launch? And if so, what did other neuro
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  Speaker 5: specialty products look like the first you know, six twelve months,
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  Speaker 5: What did that persistency curve look like? What did that
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  Speaker 5: launch adoption curve? Look like, what did they do well,
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  Speaker 5: exactly to your point, right, thinking about creating quick start
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  Speaker 5: boucher programs. Did they offer PAP the first year and
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  Speaker 5: then they said, Okay, we realized that PAP is going
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  Speaker 5: to be x percent of our budget, and then we
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  Speaker 5: know that we can bring that back down on year
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  Speaker 5: two because by then you've already built physicians, HCPs payers
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  Speaker 5: that have trust and understand the value of your product
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  Speaker 5: and are much more willing to prescribe it as well
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  Speaker 5: as support it. So thinking about tracting these shifting policy
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  Speaker 5: and industry discussions like we talked about, especially as they
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  Speaker 5: really impact specialty pharmaceuticals, and these changing dynamics are on
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  Speaker 5: top of mind for everybody in the field, right, Sheila.
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  Speaker 4: Absolutely, This year especially has been extremely busy, right, and
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  Speaker 4: challenging as we've you know, implemented that smoothing from medicare
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  Speaker 4: beneficiaries in the IRA, Right, what are those challenges and
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  Speaker 4: now we're seeing you know, a three point forty b
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  Speaker 4: you know, pilot program rebate model being considered, and you know,
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  Speaker 4: we're trying to manage all of that reimbursement challenges and
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  Speaker 4: then also continuing to take care of patients who are individuals, right,
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  Speaker 4: They all have you know, different I guess, different stories,
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  Speaker 4: They have different diagnoses, they respond differently, you know, they
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  Speaker 4: have different social factors that impact write, their ability to
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  Speaker 4: be compliant and inherit and to do well on these medications.
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  Speaker 4: So it's an awful lot of balls in the air
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  Speaker 4: at one time.
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  Speaker 5: Absolutely, And I love Sheila what you just said about
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  Speaker 5: every patient as a person. They have a backstory, they
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  Speaker 5: have family hopefully, caregivers hopefully, and that product is so
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  Speaker 5: necessary for them.
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  Speaker 4: Absolutely, I think that's what's so to me. It's it's
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  Speaker 4: so incredible. I've been in this business for quite some
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  Speaker 4: time and as we I think we're doing a little
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  Speaker 4: bit of a shift from population health management right where
• 9:55
  Speaker 4: we kind of fit, you know, we kind of it
• 9:57
  Speaker 4: was like the eighty twenty rule, where eighty percent of
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  Speaker 4: the patients you could make and it's this way, you know,
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  Speaker 4: you could expect similar results. Well, now we have all
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  Speaker 4: of these therapies that are targeted, their personalized. But with
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  Speaker 4: that comes all of the challenges, right of these individuals
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  Speaker 4: and their responses and like you said, their backstories.
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  Speaker 5: Yes, absolutely, and you know, and I think that really
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  Speaker 5: reflects on why it's critical for manufacturers and especially when
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  Speaker 5: you think about these patients support and the case management
• 10:23
  Speaker 5: teams to identify where these patients are in their journey
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  Speaker 5: and you know, really being able to say what intervention
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  Speaker 5: is needed right now. So to your point about that
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  Speaker 5: eighty twenty eighty percent of those patients probably go through
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  Speaker 5: their little or no touch, they're processing through it an
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  Speaker 5: expected clip. But then you have that other twenty percent
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  Speaker 5: that are really struggling for very unique reasons. To your point,
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  Speaker 5: it's not just a one size fits all. So you're
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  Speaker 5: thinking about that patient journey and exactly as you articulated, right,
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  Speaker 5: it's so stressful. Patients have months, sometimes years of worry
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  Speaker 5: before they get a prescription and they're finally say, oh,
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  Speaker 5: I have this, I have a diagnosis, I have description
• 11:00
  Speaker 5: in my hand. Well, that means I'm going to get
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  Speaker 5: my therapy within a few days and life is going
• 11:04
  Speaker 5: to be better or at least I'm going to remove
• 11:06
  Speaker 5: a certain amount of stress. And then once they get
• 11:10
  Speaker 5: that prescription, just getting that medication can even be a
• 11:13
  Speaker 5: major hurdle. Right, So you have these payer approvals and
• 11:16
  Speaker 5: affordability concerns that are standing in the way to your
• 11:19
  Speaker 5: point when you're thinking about these regulations and the three
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  Speaker 5: forty B impacts, and that might put a pause in
• 11:24
  Speaker 5: how somebody is then processing that prescription, if they're a hospital,
• 11:28
  Speaker 5: if they're an institution, whatever that may be. So, you know,
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  Speaker 5: it's interesting at Claritas at Cleitros RX here we actually
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  Speaker 5: analyze data from forty seven different brands and we found
• 11:39
  Speaker 5: that for every five extra days that it takes to
• 11:42
  Speaker 5: fill a prescription, the filler rate drops by thirty percent.
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  Speaker 5: Think about out thirty percent, right, So that means that
• 11:49
  Speaker 5: many patients never actually start even their prescribed therapy. So
• 11:53
  Speaker 5: they've gone through all that hassle and frustration and stress
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  Speaker 5: and driving and paying for parking at the hospital only
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  Speaker 5: to say, for whatever reason, I'm going to abandon. So
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  Speaker 5: what we think is that if pharma companies can really
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  Speaker 5: use this data and you can pinpoint patients that are
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  Speaker 5: risk of abandoning treatment and really step in with not
• 12:11
  Speaker 5: just even support, but very nuanced, specific support for that
• 12:17
  Speaker 5: exact situation that a patient is in, they can make
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  Speaker 5: a real difference in helping people to get on that
• 12:22
  Speaker 5: right medication faster.
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  Speaker 4: And it's just amazing to me. You know, I've worked
• 12:29
  Speaker 4: in you know, different facets of this industry. And you know,
• 12:32
  Speaker 4: at one point I oversaw Prior Authorization Department, and I
• 12:35
  Speaker 4: would tell my folks, you know, when we deny something
• 12:37
  Speaker 4: for somebody, we also have to have the this. Maybe
• 12:40
  Speaker 4: this isn't what's right for you now, right based on
• 12:42
  Speaker 4: our criteria the guidelines, but this is what's right because
• 12:45
  Speaker 4: they don't get better, right if you don't treat them,
• 12:48
  Speaker 4: they don't just get better and like you said, thirty percent,
• 12:51
  Speaker 4: you know, decrease. Where do they go?
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  Speaker 5: Right?
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  Speaker 4: What happens to them?
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  Speaker 5: You know? And that is exactly the key point. That
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  Speaker 5: is the area that we really need to make sure
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  Speaker 5: that we're focusing on because no one's taking this because
• 13:04
  Speaker 5: they feel like it. Right, It's not candy, it's not
• 13:07
  Speaker 5: the newis soda. It's a very necessary drug or therapy
• 13:10
  Speaker 5: for them. And this is something that the White paper
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  Speaker 5: is really looking into about what are these key drivers
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  Speaker 5: of abandonment and really what are some of the things
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  Speaker 5: that are happening Because no one's going to go through
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  Speaker 5: maybe a year or a month or something of stress
• 13:22
  Speaker 5: only to say, oh, I'm not going to move forward
• 13:24
  Speaker 5: with it. So a lot of it is you know,
• 13:26
  Speaker 5: the patient's denied coverage. That's really going to be payer related, right,
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  Speaker 5: And that was actually one of the biggest pockets that
• 13:33
  Speaker 5: we saw, or one of the biggest buckets that we saw.
• 13:36
  Speaker 5: There could be a lengthy prior authorization process also known
• 13:39
  Speaker 5: as a PA, and this could be something like you
• 13:41
  Speaker 5: need to have labs done, you need to have a
• 13:44
  Speaker 5: peer to peer review because of the high cost of
• 13:45
  Speaker 5: a medication, or maybe someone's lack of familiarity. It was
• 13:49
  Speaker 5: freshly launched and they might say, how is this really
• 13:51
  Speaker 5: differentiated from the current standard of care. You could look
• 13:54
  Speaker 5: at things like affordability, right, so really high out of
• 13:57
  Speaker 5: pocket costs from a copay or co insurance. You might
• 14:01
  Speaker 5: have a copayd buydown program if it's commercial, but if
• 14:04
  Speaker 5: this is someone who's on Medicare Medicaid, maybe they're paying cash.
• 14:08
  Speaker 5: That might be a financial barrier that is too high
• 14:10
  Speaker 5: for them. You could also look that there are breakdowns
• 14:14
  Speaker 5: that we see all the time sadly it so you're
• 14:15
  Speaker 5: probably familiar with shila. You know, communication between the prescribers,
• 14:19
  Speaker 5: the pharmacies and the patients. You might have someone calling,
• 14:22
  Speaker 5: leaving a voicemail and you're playing phone tag for the week.
• 14:24
  Speaker 5: Somebody might say, Hey, we need to have this delivered
• 14:28
  Speaker 5: during the work week, and someone might say, I'm at
• 14:30
  Speaker 5: work all day, you know, I work first, second, third shift,
• 14:32
  Speaker 5: whatever that may be. I'm not going to be home
• 14:34
  Speaker 5: to sign for it. So these are all just this
• 14:37
  Speaker 5: mailstrom of events that could happen that are resulting ultimately
• 14:40
  Speaker 5: in abandonment sadly.
• 14:42
  Speaker 4: Sure, right, it's all about the coordination, and one piece
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  Speaker 4: of that breaks down, the results can be disastrous.
• 14:50
  Speaker 5: Exactly. I think this really highlights the importance of care
• 14:52
  Speaker 5: coordination as a team and as a.
• 14:54
  Speaker 4: Village, absolutely, and effective communication right in setting expectations and
• 14:59
  Speaker 4: making sure I think especially that patients and caregivers understand
• 15:02
  Speaker 4: because I think as healthcare providers sometimes we forget, like
• 15:05
  Speaker 4: you said, that that journey that they've been through to
• 15:08
  Speaker 4: get to this point to be ready for this medication,
• 15:10
  Speaker 4: and now on that doesn't go well, it's super easy,
• 15:12
  Speaker 4: I would think, to just say, oh the heck with this,
• 15:14
  Speaker 4: right to.
• 15:16
  Speaker 5: Exactly, patient burden is a huge issue, and how do
• 15:19
  Speaker 5: you make sure that you're clearing a lot of those
• 15:22
  Speaker 5: barriers through and removing those hurdles and really understanding and
• 15:26
  Speaker 5: putting yourself in their position exactly as your articulated Sheila,
• 15:29
  Speaker 5: versus having a manufacturer first perspective.
• 15:32
  Speaker 4: So we've seen access analytics mentioned in the marketplace, So
• 15:36
  Speaker 4: can you provide a high level description of what that
• 15:39
  Speaker 4: is and how will it help address current challenges and
• 15:42
  Speaker 4: market access and patient journey analytics.
• 15:45
  Speaker 5: Absolutely, I love to talk about this, and I think
• 15:48
  Speaker 5: one of the big things that we have at this
• 15:51
  Speaker 5: point in time is everybody you know patients, like we
• 15:53
  Speaker 5: talked about that patient burden. You think about manufacturers, you
• 15:56
  Speaker 5: think about anybody in their role, they have a million
• 15:59
  Speaker 5: things they need to do in the eight, nine, ten,
• 16:01
  Speaker 5: twelve hours that they're working in a day, and just
• 16:04
  Speaker 5: really trying to say what is actually going on not
• 16:08
  Speaker 5: just the noise, but how do you get that signal
• 16:10
  Speaker 5: in the noise? And I think ultimately you can't improve
• 16:13
  Speaker 5: what you can't see, right, absolutely thinking about how do
• 16:20
  Speaker 5: you have visibility to this data? Really, what access analytics
• 16:24
  Speaker 5: is so unique is that you get insight into that
• 16:27
  Speaker 5: patient journey with our upgraded dashboards that we have, and
• 16:32
  Speaker 5: you know, it's able to really easy to explore our
• 16:35
  Speaker 5: patient data. You can spot some trends and you can
• 16:38
  Speaker 5: really quickly identify barriers. So going back to the thing
• 16:40
  Speaker 5: that there might be, you know, six things that are
• 16:43
  Speaker 5: preventing a patient from getting on board, and a manufacturer
• 16:46
  Speaker 5: might say, I don't know which one you know, or really,
• 16:48
  Speaker 5: is there something that's unique to this pocket and subpopulation
• 16:52
  Speaker 5: versus another. So really it allows a manufacturer to look
• 16:56
  Speaker 5: at these this rich data and put it into order
• 16:59
  Speaker 5: and say, you can have these really clear, intuitive visuals,
• 17:02
  Speaker 5: so it's not trying to kind of you tilt your
• 17:04
  Speaker 5: head and squinch your eyes and say, I think, but
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  Speaker 5: really you can see it all out in front of you,
• 17:09
  Speaker 5: across your portfolio, across your brands, across your patient population.
• 17:14
  Speaker 5: And then additionally, you have some really advanced filtering and
• 17:17
  Speaker 5: access analytics, and it allows teams to see, you know,
• 17:20
  Speaker 5: you can look at the overall results, or you can
• 17:22
  Speaker 5: really zoom in on granular patient populations or even specific patients,
• 17:27
  Speaker 5: so you give everyone really the access and insights that
• 17:30
  Speaker 5: they need. And I think, to something that you said earlier,
• 17:34
  Speaker 5: this is really important because we're having more patients that
• 17:36
  Speaker 5: are transferring between specialty pharmacies. So one of the key
• 17:41
  Speaker 5: aspects of this is really having that visibility to patient
• 17:45
  Speaker 5: longitudinal activity, so all the way from start to finish,
• 17:48
  Speaker 5: regardless of whether they go to another pharmacy. So this
• 17:51
  Speaker 5: access analytics platform actually allows you to track those transitions,
• 17:55
  Speaker 5: and our data shows that most cancelations happen during the
• 17:59
  Speaker 5: coverage stage. So we saw about seventy two seventy nine percent,
• 18:03
  Speaker 5: with rates that were even higher at PBM owned pharmacies.
• 18:07
  Speaker 5: And so when we by the way, when we say
• 18:08
  Speaker 5: PBM owned pharmacies for this white paper, this is just
• 18:12
  Speaker 5: to say that that is a one that is vertically
• 18:16
  Speaker 5: aligned to a PBM. So we know that there can
• 18:19
  Speaker 5: be a lot of different descriptions or definitions of independent
• 18:21
  Speaker 5: versus PBM, but that is what we have used for
• 18:24
  Speaker 5: this analysis. And so the fact that when these increase,
• 18:28
  Speaker 5: when you have these PBM owned pharmacies, now these insights
• 18:31
  Speaker 5: really empower teams to take action and keep their patients
• 18:35
  Speaker 5: on therapy and monitoring. If it goes here, we need
• 18:37
  Speaker 5: to take this action. If it goes there, we need
• 18:39
  Speaker 5: to take that action. And you know, one really important
• 18:42
  Speaker 5: aspect that we should call out is just basically that, yes,
• 18:47
  Speaker 5: there may be slightly different definitions of PBM BOS is independent,
• 18:51
  Speaker 5: but I think ultimately at the end of the day
• 18:53
  Speaker 5: is to take a huge step back and say, based
• 18:56
  Speaker 5: on these commonalities that we see patients tracking to, what
• 19:00
  Speaker 5: are ways that we can then support them.
• 19:03
  Speaker 4: You have any insights as to how this, you know,
• 19:06
  Speaker 4: vertical integration impacts that, like why are we seeing that?
• 19:12
  Speaker 4: Do you know?
• 19:13
  Speaker 5: And that's another really good question, and you know, ultimately,
• 19:16
  Speaker 5: again kind of going looking at it from an independent
• 19:18
  Speaker 5: versus vertically integrated PBM, we see that independence generally they're
• 19:23
  Speaker 5: much more community based. They can have a little bit
• 19:26
  Speaker 5: more flexibility due to less rigidive protocols that may be
• 19:29
  Speaker 5: established as what you might see in a PBM owned
• 19:32
  Speaker 5: pharmacy in which a PBM owned pharmacy might say, you
• 19:35
  Speaker 5: need to talk to this group first, this group second,
• 19:38
  Speaker 5: a very rigid set of protocols in which how to
• 19:42
  Speaker 5: respond to a patient, whereas you might see with an
• 19:44
  Speaker 5: independent you might have someone that may be a little
• 19:47
  Speaker 5: more flexible, able to call or find a way to
• 19:50
  Speaker 5: creatively respond to a patient need. So we think ultimately
• 19:54
  Speaker 5: the structure that provides PBM owned pharmacies and enables them
• 19:58
  Speaker 5: to meet these high level goals, ultimately these independent pharmacies
• 20:03
  Speaker 5: are going to be more flexible and able to support
• 20:06
  Speaker 5: patients in a different way.
• 20:09
  Speaker 4: So what are the top three ways that you know
• 20:12
  Speaker 4: the clients will benefit from excess analytics.
• 20:16
  Speaker 5: So I think the big part here is it's really
• 20:19
  Speaker 5: easy to overlook the challenges that patients face just trying
• 20:22
  Speaker 5: to get on treatment right. So, going back to what
• 20:24
  Speaker 5: we talked about at the beginning of this, there's really
• 20:27
  Speaker 5: so many barriers that are out there, and it's our
• 20:29
  Speaker 5: job to find ways to help remove them, you know,
• 20:32
  Speaker 5: identify them and say this is a next best action.
• 20:35
  Speaker 5: This is how you're going to kind of clear the
• 20:37
  Speaker 5: playing field here. So I would say this is where
• 20:39
  Speaker 5: access analytics makes a real difference, and really thinking about it,
• 20:44
  Speaker 5: by cutting through these overwhelming amounts of data that organizations
• 20:48
  Speaker 5: deal with today, we can help pinpoint the biggest areas
• 20:51
  Speaker 5: of concern or risk and really give targeted interventions much
• 20:55
  Speaker 5: more effectively. Think about it like laser focusing and going
• 20:58
  Speaker 5: back to that data deluge that we are talking about,
• 21:01
  Speaker 5: how do you get that noise, remove it and get
• 21:04
  Speaker 5: that signal and parse that out. So I would say
• 21:07
  Speaker 5: that clients at Claritas AREX have seen three distinct key benefits.
• 21:13
  Speaker 5: So the first is that clients need a single comprehensive
• 21:18
  Speaker 5: view of the entire patient journey to need depth, breadth,
• 21:22
  Speaker 5: and we need to see everything from enrollments and approvals
• 21:24
  Speaker 5: that therapy starts. You're going to look at copay support
• 21:28
  Speaker 5: and ultimately adherents. Right, So once someone's got on therapy,
• 21:31
  Speaker 5: that doesn't mean that's the end of the road. You
• 21:33
  Speaker 5: need to make sure that you're clearing any potential barriers
• 21:35
  Speaker 5: that may occur afterwards, thinking about rios, thinking about changing insurance,
• 21:40
  Speaker 5: all of that that I think all of us as
• 21:42
  Speaker 5: patients have ultimately gone through. And then you have these
• 21:45
  Speaker 5: multiple stakeholders, So you're thinking you have your hub teams,
• 21:48
  Speaker 5: you have your payers, you have finance. Although we have
• 21:51
  Speaker 5: executive leadership. They've all expressed finding value and having a
• 21:56
  Speaker 5: unified visual approach and really giving them the ability to
• 22:00
  Speaker 5: understand and improve patient access and support. There's need to
• 22:04
  Speaker 5: have an easy to view executive dashboard that provides key
• 22:07
  Speaker 5: business metrics and performance snapshots across multiple timeframes. Really, so
• 22:11
  Speaker 5: it's rolling up all that rich information because we all
• 22:14
  Speaker 5: know the CEO doesn't have time to go through a
• 22:16
  Speaker 5: thirty minute deck, right They want to see everything right now.
• 22:19
  Speaker 5: Preferably on their iPad and being able to say, Okay,
• 22:23
  Speaker 5: that's how we're performing as a snapshot in time, and
• 22:26
  Speaker 5: you know, I love this that we had one customer
• 22:28
  Speaker 5: put it. We get a usable dashboard with data from
• 22:31
  Speaker 5: as recently as midnight, and by eight am the next
• 22:34
  Speaker 5: day we have the full picture. So that level of
• 22:38
  Speaker 5: real time insight is so incredibly powerful for making these
• 22:41
  Speaker 5: really timely and informed decisions.
• 22:45
  Speaker 4: How do you get the data to do that?
• 22:48
  Speaker 5: So that is an excellent question as well, And this
• 22:51
  Speaker 5: is actually pulling in from our clients and being able
• 22:55
  Speaker 5: to amass all of it and put it in a
• 22:58
  Speaker 5: very streamlined, clear format for them because oftentimes, you know,
• 23:03
  Speaker 5: I did this myself. I was a commercial data strategy
• 23:06
  Speaker 5: and you're trying, like we talked about, you can have
• 23:08
  Speaker 5: it in all these different formats of spreadsheets and CSV
• 23:10
  Speaker 5: files and whatever it may be. And we actually can
• 23:13
  Speaker 5: take all of that from the different providers and be
• 23:17
  Speaker 5: able to affinitize and harmonize it and then put it
• 23:21
  Speaker 5: into this dashboard that people can then review, look at
• 23:24
  Speaker 5: and say aha. So we're basically turning people from being
• 23:29
  Speaker 5: spreadsheet jockeys into analysts and being able to support the patients.
• 23:35
  Speaker 4: So how does access analytics change daily work for pharma
• 23:39
  Speaker 4: commercial and access teams.
• 23:42
  Speaker 5: So, as we just talked about, I think this really
• 23:44
  Speaker 5: allows people to focus on the necessary people and populations
• 23:50
  Speaker 5: during the day. So right now, we see a lot
• 23:53
  Speaker 5: of people that are doing these time consuming manual data
• 23:56
  Speaker 5: collection and they're trying to massage the data, the data
• 24:00
  Speaker 5: and put it together and then say, okay, once they've
• 24:02
  Speaker 5: done all of that, let's make some sense of it.
• 24:05
  Speaker 5: So really, what access analytics allows you to do is
• 24:07
  Speaker 5: just eliminate all that time consuming collection and analysis and
• 24:12
  Speaker 5: really automate this reporting. So that way you're streamlining your
• 24:15
  Speaker 5: operations and you're enabling your teams to focus on patient
• 24:18
  Speaker 5: care and program improvement. And then at the same time
• 24:22
  Speaker 5: you're gaining this expert actual insights for enhanced forecasting, and
• 24:25
  Speaker 5: you're also having a lot stronger market access results. So
• 24:29
  Speaker 5: you're taking people away from kind of being data wranglers
• 24:32
  Speaker 5: with their lasso and with all these spreadsheets and really
• 24:35
  Speaker 5: being able to say, once you get to the office,
• 24:37
  Speaker 5: once you open up your emails, you can look at
• 24:39
  Speaker 5: something that is clean, defined, logical, and you can spend
• 24:44
  Speaker 5: your hours focusing on that.
• 24:48
  Speaker 4: So Those are great insights into how access analytics help
• 24:51
  Speaker 4: teams every day. So let's switch gears a little bit
• 24:54
  Speaker 4: and address some common myths about specialty pharmacy in the
• 24:57
  Speaker 4: patient journey. Given the complexity, how do specialty pharmacies make
• 25:01
  Speaker 4: sure patients stay safe and on track with their medications?
• 25:06
  Speaker 5: So you know, what we see is that when a
• 25:08
  Speaker 5: physician decides that a patient needs a specific medicine, acting
• 25:11
  Speaker 5: quickly is crucial. And I think, Sheila, this is something
• 25:14
  Speaker 5: that is near and dear to your heart as well. Right,
• 25:16
  Speaker 5: this isn't just for the quality of life, but it's
• 25:19
  Speaker 5: also potentially to slow or even prevent a disease from worsening.
• 25:23
  Speaker 5: So you need to make sure that you get this
• 25:25
  Speaker 5: on quickly. And this is going to impact the entire
• 25:28
  Speaker 5: care ecosystem.
• 25:29
  Speaker 4: Right.
• 25:29
  Speaker 5: So we talked about before No man is an island.
• 25:32
  Speaker 5: You have patients, you have families, you have caregivers, and
• 25:36
  Speaker 5: it's really essential to have clear visibility into where that
• 25:39
  Speaker 5: patient is along their treatment journey. So think about it.
• 25:43
  Speaker 5: Are they waiting on a benefits check, which, okay, that's fine,
• 25:46
  Speaker 5: it might take a little bit of time for that.
• 25:48
  Speaker 5: You might be working through affordability issues with a specialty
• 25:51
  Speaker 5: pharmacy team. You know, then you have to think, well,
• 25:53
  Speaker 5: if there's a problem, the specialty pharmacy, the hub, and
• 25:57
  Speaker 5: the manufacturer, they all need to be commune, dating and
• 26:00
  Speaker 5: coordinating a solution for that patient. And so this is
• 26:04
  Speaker 5: exactly what we actually covered in a recent Claritas Rix
• 26:07
  Speaker 5: white paper which I helped author very proudly and were
• 26:10
  Speaker 5: highlighting just how important patient visibility is. Right, a lot
• 26:14
  Speaker 5: of things can be very opaque, it can be very difficult.
• 26:17
  Speaker 5: You're already dealing with a host of other things in
• 26:19
  Speaker 5: your personal life and now you have this component going on.
• 26:23
  Speaker 5: So getting and staying on therapy can be delayed every
• 26:26
  Speaker 5: single time of prescription transfers between pharmacies. It doesn't matter
• 26:30
  Speaker 5: if it's an independent to an independent independent to PBM,
• 26:33
  Speaker 5: or even within vertically aligned networks. So each transfer that
• 26:37
  Speaker 5: happens adds another step increasing their risk of patients not
• 26:41
  Speaker 5: starting or staying on therapy. You know, think back to
• 26:44
  Speaker 5: that thirty percent number that we have. Each time that
• 26:47
  Speaker 5: an x number of days have transpired, there is a
• 26:50
  Speaker 5: greater chance that that patient will not fill And so
• 26:53
  Speaker 5: our solution really helps users easily track and evaluate these
• 26:57
  Speaker 5: transitions using that specialty pharmacy in the hub data. And
• 27:01
  Speaker 5: I think also it standardizes data from different sources like
• 27:04
  Speaker 5: we talked about to create these meaningful KPIs, making it
• 27:07
  Speaker 5: easier to compare the results at the end of the day.
• 27:10
  Speaker 5: And really the benefit of this is that it reduces
• 27:13
  Speaker 5: miscommunication and it saves valuable time and effort, and that
• 27:17
  Speaker 5: in turn lets their teams focus on supporting patients and
• 27:20
  Speaker 5: not chasing down spreadsheets.
• 27:23
  Speaker 4: So why do many patients abandon their specialty prescriptions before
• 27:26
  Speaker 4: they even start therapy?
• 27:29
  Speaker 5: You know, and thinking back to what we started talking
• 27:31
  Speaker 5: about a little bit ago, this really goes against what
• 27:33
  Speaker 5: you might expect. And this is something that we explored
• 27:36
  Speaker 5: in our white paper and when we talk about patient abandonment,
• 27:39
  Speaker 5: so thinking about that's when a patient never even fills
• 27:42
  Speaker 5: after they get that first prescription. There are many reasons
• 27:48
  Speaker 5: behind it, and you know, barriers can include things like
• 27:50
  Speaker 5: these really complex pay requirements, like we talked about that
• 27:53
  Speaker 5: extra lab work, that peer to peer reviews, meaning to
• 27:56
  Speaker 5: coordinate with the ensure. Both of these take a lot
• 27:59
  Speaker 5: of time and effort, and like we talked about before,
• 28:01
  Speaker 5: these financial concerns, these high copays, these deductibles, you know,
• 28:05
  Speaker 5: think about the impact of maximizers and whatnot, and then
• 28:09
  Speaker 5: even those communication breakdowns. You know, one of the sad
• 28:12
  Speaker 5: things that I've really seen in the pharma in my
• 28:14
  Speaker 5: time with pharma was that there is something as simple
• 28:17
  Speaker 5: as outdated contact information that a pharmacy or an office had,
• 28:21
  Speaker 5: and so you had a patient saying I really need
• 28:23
  Speaker 5: to get this medication. The pharmacy says, I've tried to
• 28:26
  Speaker 5: call them three times, and oftentimes after the third time
• 28:29
  Speaker 5: they might close out that prescription and say, I tried
• 28:33
  Speaker 5: to reach them. I don't know what's going on. So
• 28:35
  Speaker 5: something as simple as that that can really lead to
• 28:37
  Speaker 5: a lot of miss calls and frustration. And then when
• 28:41
  Speaker 5: you think about it, any one of these hurdles can
• 28:43
  Speaker 5: be discouraging on its own right, it's very frustrating, But
• 28:46
  Speaker 5: then you can have the opportunity, realistically, is that they're
• 28:49
  Speaker 5: going to stack up, and that can just become so
• 28:52
  Speaker 5: incredibly overwhelming for patients and caregivers that anyone that's involved
• 28:55
  Speaker 5: in this process. And sometimes, you know, this can lead
• 28:58
  Speaker 5: to patients just simply giving up on their medication. They
• 29:02
  Speaker 5: might just say, you know, I'm having to go to
• 29:04
  Speaker 5: a doctor. I'm having to get poked, I'm having to
• 29:06
  Speaker 5: get a biopsy, I'm having to do these sleep tests,
• 29:08
  Speaker 5: I'm having to do whatever it may be. And now
• 29:10
  Speaker 5: you're telling me after doing that and working, now I
• 29:14
  Speaker 5: need to just sit here and follow and burd dog
• 29:17
  Speaker 5: something up. And so it just might say I'm going
• 29:20
  Speaker 5: to stop. I'm going to I don't have the energy
• 29:22
  Speaker 5: for this. So I think going back to it, even
• 29:25
  Speaker 5: if it really seems surprising that burden can just be
• 29:28
  Speaker 5: too much, and they might just say I'll deal with
• 29:30
  Speaker 5: it later, and that just sadly really turns into never
• 29:33
  Speaker 5: starting therapy at all. And Sheila, I imagine this is something
• 29:35
  Speaker 5: that you've had to struggle.
• 29:36
  Speaker 4: With absolutely, you know. I hear from our specialty pharmacies
• 29:41
  Speaker 4: all the time that coverage and affordability issues, you know,
• 29:44
  Speaker 4: are definitely barriers and do cause patients to walk away.
• 29:48
  Speaker 4: I think also again it's that understanding, right, I mean,
• 29:52
  Speaker 4: I think I think we've seen such a shift from
• 29:54
  Speaker 4: the days when you know, patients would go and they'd
• 29:56
  Speaker 4: follow everything that their doctor said or their pharmacist and
• 29:59
  Speaker 4: you know, not ask any questions. Now today people want
• 30:01
  Speaker 4: to understand why am I doing these things, and I
• 30:04
  Speaker 4: think it's if they if they understood better. You know,
• 30:07
  Speaker 4: why do we have to do these things? Why are
• 30:09
  Speaker 4: there so many steps to make sure that this drug
• 30:10
  Speaker 4: is appropriate for you? I think maybe you know, we
• 30:14
  Speaker 4: would get better buy in right, or people wouldn't lose
• 30:17
  Speaker 4: that motivation to keep going. Really it shouldn't be so hard.
• 30:21
  Speaker 4: But I think kind of making them part of the process,
• 30:24
  Speaker 4: you know, doing it with them, not to them, is key.
• 30:28
  Speaker 5: Absolutely, Sheila. I really love what you're saying there and
• 30:31
  Speaker 5: thinking about the fact that how can patients and their
• 30:34
  Speaker 5: caregivers better be better advocates for them? But I think conversely,
• 30:39
  Speaker 5: you know, like clitos Rex is helping companies to be
• 30:42
  Speaker 5: advocates for these patients as well, and you know, thinking
• 30:45
  Speaker 5: about all these key factors, and it's just so important
• 30:47
  Speaker 5: to remember that technology and data integration can really help
• 30:51
  Speaker 5: streamline the patient journey, and it can help reduce those
• 30:54
  Speaker 5: barriers and really helps put focus on where there's value,
• 30:57
  Speaker 5: right on the patients and caregivers who need that assistance.
• 31:00
  Speaker 5: So using that knowledge, using technology, all of this to
• 31:03
  Speaker 5: help everybody be proper advocates so that patients can get untimely,
• 31:07
  Speaker 5: inappropriate therapy.
• 31:10
  Speaker 4: Absolutely. You know, one of the my least favorite phrases
• 31:13
  Speaker 4: is we've always done it this way, right, And I
• 31:16
  Speaker 4: think having the data and having this technology and these
• 31:18
  Speaker 4: insights that you can provide helps specialty pharmacies or you know,
• 31:22
  Speaker 4: some of your other partners to kind of look at
• 31:24
  Speaker 4: their processes and refine them and retool them.
• 31:27
  Speaker 3: Right.
• 31:27
  Speaker 4: And as the treatment journey and the patient journey and
• 31:31
  Speaker 4: these incredible medications continue to evolve, so must our processes exactly.
• 31:36
  Speaker 5: And just because we've always done it that way doesn't
• 31:39
  Speaker 5: mean that current state should allow that to continue. You know,
• 31:42
  Speaker 5: things are constantly evolving again, like you talked about regulations, processes, technology,
• 31:47
  Speaker 5: all of that. So why not leverage and utilize what
• 31:51
  Speaker 5: is available now and really give it a chance for
• 31:53
  Speaker 5: companies to take a step back and say, not what
• 31:56
  Speaker 5: have I done? But what could I do? What is that?
• 31:59
  Speaker 5: What is the a big blue sky approach? You know?
• 32:02
  Speaker 5: What could be the way that we can make sure
• 32:03
  Speaker 5: that we're definitely supporting people effectively, efficiently and really empower
• 32:10
  Speaker 5: ourselves to take that next step.
• 32:13
  Speaker 4: Awesome? Well, thank you so much Chilly for chatting with
• 32:15
  Speaker 4: me and sharing this valuable information.
• 32:18
  Speaker 5: I've had a wonderful time today, Shila, Thank you so
• 32:20
  Speaker 5: much for having me really enjoying this conversation about this
• 32:23
  Speaker 5: patient centered care and access analytics and allowing me to
• 32:26
  Speaker 5: geek out with you.
• 32:28
  Speaker 4: Awesome. As a reminder, NSP corporate members are invited to
• 32:32
  Speaker 4: be my guest and one complimentary podcast per year. For
• 32:35
  Speaker 4: more information about this or other NSP membership benefits and events,
• 32:39
  Speaker 4: please feel free to reach out to membership at NASP
• 32:43
  Speaker 4: n E T dot org. We visit our website at
• 32:46
  Speaker 4: www dot NASP n et dot org. Until next time,
• 32:51
  Speaker 4: have a great day.