As the novel coronavirus spread across our country and the world, people were told to isolate at home—and many have followed that advice, fearing that even a trip to the pharmacy to pick up needed medications could put them in danger.
Some of that uncertainty eased as time went on, but now we’re seeing new spikes in many areas. Especially wary of the virus’s spread are those with compromised immune systems or comorbidities that make them particularly susceptible to complications of infection.
Because of the complexity of the people they serve, specialty pharmacies needed to take proactive steps in recent years to help patients access and ensure continuity of care. That has become more pressing as we’ve confronted the pandemic, and it has spurred us to make additional changes.
The question for us has been: How can we be, in effect, more “hands on” while keeping a safe distance? How can we be more “in touch” with patients through tools and technology that don’t require physical contact?
Challenges of specialty pharmacy care
Individuals receiving specialty medications have rare, complex conditions; the largest groups are those with autoimmune disorders like rheumatoid arthritis, chronic conditions like kidney disease and life-threatening diseases like cancer. Their prescriptions are often more costly, require additional approvals from insurers and physicians, need special delivery and storage, and may have side effects that are difficult to manage. Some drugs are also administered by infusion or injection.
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When patients experience delays in starting their prescriptions or coping with their associated side effects, they run the risk of discontinuing the drugs. That, in turn, means more patients ending up in the hospital or experiencing health complications.
For these patients, life is difficult enough without a pandemic.
Seeking answers through technology
Prior to the COVID-19 pandemic, CVS Specialty was already working to address pain points in specialty pharmacy care with the goal of creating a high-touch experience with digital or virtual tools that help facilitate better access, convenience and care.
During the pandemic, these tools and our model became even more critical for specialty pharmacy patients who rely on these medications to manage their complex conditions. And, with that, we’ve seen increases in use and engagement of these types of tools. This has demonstrated the utility and impact of these innovations and has solidified the reality that, truly, “no touch” is the new “high touch.”
For example, we learned:
- Eliminating barriers to treatment access is critical. At the end of the day, helping patients get started on their medications faster can have a significant impact on their health.
- Throughout the pandemic, more prescribers, many of whom were also caring for patients virtually, have come to rely on our automated process that securely gathers appropriate patient information, including insurance details, lab results and diagnosis codes, through a doctor’s electronic health record (EHR) system. This expedited process has helped patients get on treatment more quickly.
- Once the prescription is ready, vulnerable specialty patients who are trying to avoid unnecessary exposure should not have to be concerned about how to safely get access to their medication. Throughout the pandemic, it has been critical that these vulnerable patients have flexibility in how they get their medication. With this insight, we’ve leaned into mail infrastructure and encouraged specialty patients to stay safely at home as much as possible.
- Information and support on demand are in demand, especially in these uncertain times.
- From the day a patient is prescribed a specialty medication, they can receive real-time updates via email or text on prescription approvals and delivery. And the numbers tell the story best—among patients who use this system, 17.5% are more likely to refill their first prescription. Within the past year, we’ve seen a 13% increase in patient message opt-ins.
- Going beyond email and text, secure two-way messaging allows patients to communicate with their care team in real time. Nurses can help with challenges patients encounter with medications—think managing side effects, interpreting symptoms or lab results—all of which can improve adherence. For example, recognizing one patient was having trouble finding the alcohol pads they needed for their injection medication because of high demand, a nurse quickly added a box to their order. While such a small task, it provided this patient much-needed peace of mind amid the disruption. In March, the secure messaging platform saw a nearly 30% increase in encounter volume as care teams helped patients manage new challenges like this. The result? Better health outcomes and lower costs—a win-win for all.
- Advanced analytics can enable more precise interventions. An effective utilization management system, using digital technology that tracks patient medication use, refill patterns and excess supply of certain specialty drugs can identify gaps in care and ensure support is delivered at the right moment via the right channel for each patient. These touchpoints help promote adherence and avoid unnecessary emergency room visits, reducing wasteful spend and overall costs.
- Tools can only be truly useful if patients are aware of their value. Getting the word out about technology and offerings is critical for patients to adopt them. Since the pandemic began, CVS Health has sent messages to more than 268,000 specialty patients informing them of available COVID-19 resources, digital tools and available services. Over 80% of patients have opted in to email and text notifications.
Staying 'in touch'
The enormous challenges presented by the COVID-19 pandemic have reminded us of what is most important: finding ways to connect with specialty patients so they feel supported and continue to access important care and pharmacy services—while limiting their exposure to the virus.
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As a leading specialty pharmacy, we understand how critical the drive to digital is. The pandemic has underscored the value of technologies that provide “high-touch” care through “no-touch” innovation to enable better communication, contactless access to important treatments and personalized remote pharmacy care.
Prem Shah is the executive vice president for specialty pharmacy and product innovation at CVS Health.