The expert: 

Melissa Mulchahey, Vice President, Innovative Field Solutions Business Development and Strategy, Xcenda

The solution: 
Outsourced reimbursement and access support; provider education programs

The stats:

• Fewer than one in five patients know about the assistance available to them from manufacturers
• Only 40% of providers are "very aware" of patient services

Q: How has technology changed your approach to field solutions?

Melissa Mulchahey: In the past, field teams’ interactions with healthcare provider offices were often driven by target lists and routing plans rather than data. Currently, interest from our pharmaceutical partners in incorporating different patient and product data sources as part of the territory management approach is on the rise. COVID-19 has escalated this shift. We are engaging with existing and new clients to craft compliant reimbursement and access support strategies that incorporate various data streams across the patient and product continuum.

Q: How does the payer landscape impact field solutions?
MM: We see high levels of payer utilization management techniques when it comes to specialty drugs, so that remains a key element of our approach to supporting these products. It is important for access and reimbursement associates to keep providers aware of formulary placement and payer coverage policy changes, as well as payer-specific requirements as they are navigating through utilization management processes.

Q: As more complex therapies enter the market, how do you adapt your services?

MM: Cell and gene therapies can be very complicated, costly types of regimens, requiring high levels of case management support across multiple patient and product stakeholders. Supporting complex therapies like these does demand a shift in focus and a customized support strategy. The access and reimbursement specialist can play a key role in that case management process that is intrinsic to supporting these types of therapies. Compliantly partnering with others across the ecosystem to make sure that no patient or provider is left behind.

Q: How has COVID-19 affected your reliance on digital technology for field solutions?

MM: COVID–19 has escalated a shift in support approaches as well as support techniques (e.g., in-person to virtual). Other examples of our recent support innovations include the need for digital versions of support materials such as reimbursement toolkits and the ability for patients to digitally sign support applications.

Q: How does field support "pay off" for manufacturers in terms of patient access?

MM: The field team plays a key role in helping reduce delays in access to care and prescription abandonment. Our teams do this by helping the provider’s staff understand the resources that are available to patients for support and educating the offices on navigating the utilization management processes for a therapy. We often act as an extension of the patient support services team by providing live and virtual support, and Xcenda field teams are able to drive patient support services utilization uptake by more than 25 percent. Because we are typically able to support providers regardless of their patient support services usage, we ensure patients and providers receive the education and support they need.

Q: What other commercialization services integrate well with field solutions?

MM: Our most common partner is patient support services — we often say we’re two sides of the same coin. This is because we are both focused on navigating patients and providers through the processes of starting and staying on therapy. Exposure modeling is also very important so that manufacturers can develop an adequate copay and patient assistance program. Industry benchmarking in terms of access and reimbursement, as well as patient services, helps manufacturers understand the product landscape and the types of services that are available for competitive products and how to distinguish themselves in a crowded therapeutic space.

Q: What are common mistakes manufacturers make with regard to field services and commercialization strategy?

MM: One current trend is manufacturers outsourcing services with multiple vendors versus selecting a single vendor to provide multiple services. When manufacturers work with multiple vendors across the payer, access, and reimbursement ecosystem, as well as trade and distribution, it is important to have a clear plan for integration and communication. Not only at launch but in ongoing efforts as well.