5 mins with... Tara Herington, Cardinal Health

Tara Herington is the Vice President at Cardinal Health Sonexus Access and Patient Support. We asked her what a patient hub service is and how it can help with patient adherence to medication. 

What impact has the pandemic had on new therapies and medication launches? 
During the pandemic, many drug approvals and launches were virtually put on hold as government agencies dedicated resources to COVID-19 drug and therapy approvals. Additionally, site inspections, necessary for drug approval, slowed due to travel restrictions, creating a long backlog of drugs to be approved, leaving vulnerable patient populations waiting.

The drugs and therapies that make it past the approval phase, or that launched during the pandemic have their own challenges. Launching a new therapy requires tremendous effort and communication in order to make sure medication information reaches as many physicians, patients, and payers as possible. That’s followed by getting feedback from all those involved, to understand where friction points might be slowing or stopping the patient from getting that therapy as soon as possible.

During the pandemic, many of those paths of communication were blocked, which forced pharmaceutical manufacturers and sponsors to either pause their launches, or pivot and adapt, not only to the approval process, but figuring out how patients could get medications, especially if they needed to travel or therapies were to be administered in a hospital setting that may have been overwhelmed with COVID patients.

What is the purpose of a patient hub service? 
A patient hub services addresses and removes obstacles to care along the patient treatment journey. 

Pharmaceutical manufacturers understand that many drugs or therapies, especially as the world moves towards more precision medications, can be difficult to understand for both doctors and patients – but they can also have lifesaving outcomes if navigating the healthcare system was easier. 

For the more complex therapies and drugs, manufacturers develop patient assistance programs that can help with everything from navigating insurance and benefits investigations, to understanding the best way pharmaceutical companies or providers should communicate with specific patients, to understanding adherence issues and providing medical information.

What support does Cardinal Health's Sonexus Access and Patient Support service provide?

Our team includes nurses and compliance professionals who guide our programme to include the unique needs of patients. We leverage technology and data-driven insights to consistently understand and improve the patient experience. 

An example of this includes how we used a natural language processing tool that we developed using AI/machine learning to better listen to patient adherence concerns during the pandemic. By analysing patient calls, we learned that a growing number of patients were having difficulty affording their medications during the pandemic.

Instead of simply leaving the concerns for the patient and doctor to work through, this information allowed the pharmaceutical manufacturer to analyse their programme, and ultimately adjust the patient assistance eligibility criteria during this challenging time — enabling more patients to stay on the medication without financial hardship.

How can a patient hub service help with patient adherence? 
Non-adherence is responsible for approximately 125,000 preventable deaths in the United States, because it’s not an easy fix. It involves both health (side effects, how to take the drug, etc) and socioeconomic factors such as costs, booking travel and mental health, etc.

While cost is generally seen as the primary reason patients never start, or don’t stay on a medication,
a financial strain may be exacerbated by not knowing how much a drug costs when it’s prescribed. Patient hubs take on the task of figuring this out by handling benefits investigation – before or right after a drug is prescribed. The more advanced patient hubs even offer electronic benefits investigations that can get answers within hours.

Beyond cost, research shows that many doctors, particularly those in specialty fields like oncology, do not have the time to consider non-health-related factors when prescribing medication. Patient hubs often play the intermediary between patients, doctors and manufacturers, by ensuring patients understand how often to take a treatment, setting up travel plans for therapies or infusions, and sharing medical information. 

Patient-focused hubs will also develop communications plans for patients based on how they like to receive communications and what type of communication they should receive and when. For example, older patients may expect a phone call before beginning treatment, while millennials will postpone a treatment if a phone call is a requirement. 

Just as medication and therapies are becoming more personalised, patient hubs and how they support patients are also taking a personalised approach – leading to better medication adherence. 

What do healthcare organisations need to consider when creating a patient hub service? 
The more complicated the medication or therapy, the more need there is for better communication. 

Manufacturers should select a hub services partner and map out the patient support strategy at least 12 months prior to launching a new therapy, so a well-developed patient engagement plan can be built in advance.

It’s a common mistake to think that if a hub services programme only targets a small number of patients, they don’t need much time to create it.  But it’s not about the number of patients, it’s about the complexity of the reimbursement process, the number of partners and stakeholders that need to be aligned to support the patient journey. 

Healthcare organisations, on the other hand, should think beyond standard care options. I was working with a peer in the precision medicine space who was proud about his company being patient-centric because each dose of their medication is developed to be specific to an individual patient. But I pushed him further and asked the question: “How do patients actually get to the clinics for their infusions?” and the answer was silence.

No one had thought about the fact that patients often live several hours away from these specialised clinics, they often cannot drive themselves for their treatments, parking at the sites is expensive, and patients and care partners have to ask for time off work in preparation for their infusions. Being patient-centric means healthcare leaders need to include patients in the planning process and put themselves in the shoes of patients.

• An edited version of this article appears in the October issue of Healthcare Global