The journey of the specialty pharmacy patient is a complex and expensive process, as most any hub services participant knows. It starts when the patient is diagnosed with a life-changing chronic or complicated condition and the pharmacy receives the order for a specialty drug.
Due to the high costs of specialty medications, patients are saddled with hurdles to get to therapy. One example is satisfying insurance requirements for prescription enrollment and payment. Hub services support the patient traversing the many complexities and serve as an intermediary between the physician, patient, payer and drug manufacturer.
Even with the assistance of these intermediaries, manual processes and minimal standards exist. Hub services companies face their own unique challenges to help physicians and patients effectively navigate the specialty approval and fulfillment process. Here’s a look:
The United States spent approximately $577 billion on prescription drugs in 2021. Approximately half of this spend ($285 billion) was attributable to specialty medications. Even though less than 2% of the population uses specialty drugs, those prescriptions account for a staggering 51% of total pharmacy spending, according to Evernorth’s 2020 Drug Trend Report.
Specialty medication costs and use are skyrocketing as evidenced by:
These barriers result in significantly higher risks of complications, negative impacts on clinical outcomes, and even mortality.
Once you understand the factors contributing to slowdowns in the process ─ causing people to abandon their specialty prescriptions ─ you can create an efficient and effective tech-driven patient access strategy to accelerate time to therapy.
In the next blog, we will explore a variety of use cases applying artificial intelligence (AI) to modernize the specialty pharmacy hub’s multi-layer communication processes that touch hundreds to thousands of participants daily. We will also review key linkage points in the patient’s journey to digitally automate to provide care faster anytime and anywhere. Specialty healthcare teams supporting the sickest patients must be equipped with the right tools to help them do their jobs.
With over two decades of technology entrepreneurship background, Krishna Kurapati started QliqSOFT with the strong desire to solve clinical collaboration and workflow challenges in US Healthcare. During the late 90s, Krishna co-founded IPCell to build the first Cable IP Telephony switch, eventually selling the company to Cisco Systems. In 2003, he started Sipera (acquired by Avaya Systems) to solve security issues for Unified Communications' and raised over $30MM in venture funding. Additionally, he has been actively involved in the early-stage financing of startups in both the US and India.
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