At the Informa Patient Support Services Congress (November 20-21, 2024), industry leaders from biotech, pharma, and solution providers convened to explore the evolving landscape of patient support. Discussions addressed pivotal topics, including access strategies, affordability, reimbursement, and technology, all critical to shaping modern patient support programs (PSPs).

Highlights:

• Hub Models, AI, and Data Enablers: Essential tools for advancing patient support services (PSS)
• The Inflation Reduction Act (IRA) Journey Continues: Insights from IQVIA experts Nancy McGee, JD, DrPH and Jenn Millard, MBA on navigating Medicare Part D redesign
• Holistic, Adaptable Strategies: Emphasizing the importance of building agile programs to address evolving patient needs

These discussions reinforced the need for flexible, patient-forward support. Five key insights emerged, guiding the path forward for pharma teams striving to deliver impactful PSPs.

1. Keeping Patients at the Center: Patient-centricity is essential but requires stronger integration into program design

Pharma strives to create seamless experiences that address patient needs while also capturing valuable data. However, achieving this goal requires careful trade-offs when balancing it with the best of breed services offered by different providers. Fragmented approaches can disrupt the patient's journey, negatively impacting both the patient's experience and treatment outcomes. It is crucial to maintain a patient-forward approach, ensuring that patients remain at the core of program design.

2. Designing Strategic Programs: Utilizing external expertise and support for effective patient support services

The congress underscored the value of third-party advisory support in helping pharma navigate the complexities of patient services. Internal assessments often fall short, making external expertise critical to building programs that are fit-for-purpose and adaptable.

Key areas of focus included:

• Hub Models: Balancing internal and external resources for greater efficiency
• Free Goods and PAPs: Optimizing design to enhance accessibility while managing costs
• Streamlined Operations: Modernizing workflows to ensure scalability and sustainability

Collaboration with trusted advisors emerged as a crucial factor in creating programs that align with both patient and business needs.

3. Harnessing Technology and Data: Transforming patient services with AI and automation

Technology, particularly artificial intelligence (AI), is reshaping patient services, offering opportunities for automation, predictive analytics, and personalized interventions. Organizations at varying levels of AI maturity are finding innovative ways to enhance their programs.

Key applications discussed included:

• Identifying at-risk patients to prevent non-adherence
• Supporting case managers and call centers through CRM platforms and automation
• Using AI for quality monitoring to improve efficiency and outcomes

While AI offers immense potential, success hinges on defining its purpose, securing leadership investment, and ensuring alignment with compliance teams.

4. Demonstrating Program Value: Continuous evolution of patient support programs

PSPs must continuously evolve, and the PSS Congress highlighted the importance of annual evaluations to ensure programs remain impactful and aligned with strategic goals. Leaders stressed the need for robust KPI frameworks and relevant metrics to track adherence, patient satisfaction, and operational performance. Equally important is effectively communicating program value to leadership and stakeholders. Clear, compliant metrics—such as improved persistence rates—help demonstrate the value and overall impact.

5. Navigating the New Regulatory Landscape: Preparing for Medicare Part D redesign

The evolving regulatory landscape, particularly the Inflation Reduction Act (IRA), presents both challenges and opportunities for PSPs. Key discussions explored how these changes will impact free goods programs, call center workflows, and program design. As we approach the Medicare Part D redesign in January, patient support professionals play a crucial role in educating patients and their care partners to navigate these transitions effectively. Physician offices and local pharmacies will become sources for information about how to opt in to the Medicare Prescription Payment Program, but these channels can quickly become overwhelmed. Ensuring that manufacturer-sponsored PSPs are ready with educational materials and guidance for patients, physicians, and pharmacies will be an opportunity for Patient Support Programs to help with the overall education effort. This will be particularly important during the first quarter of 2025 when new benefits come into effect and calls to payers and PBMs will dramatically rise. To assist with these efforts, IQVIA has developed a Medicare Part D Redesign Planning Guide and Checklist to support organizations in creating smooth transitions and building patient-forward strategies.

Next Generation Patient Support: Bridging compliance and innovation

The Informa PSS Congress underscored the vital relationship between innovation, operational excellence, and compliance in shaping the future of Patient Support Programs (PSPs). The challenge is not compliance itself but the silos between compliance and other teams, which lead to frustration and a perception that compliance is hindering PSP innovation. A telling example from the Informa PSS Congress was the simultaneous scheduling of Innovation & Operations Breakout Track A and Compliance & Legal Breakout Track B, forcing speakers and attendees to make a choice and reinforcing these silos.

To challenge the status quo and accelerate incremental and decisive changes that meet patients’ evolving needs, we need to reach across the aisle and strategize jointly with compliance teams, embarking on the innovation journey together. Otherwise, we are left in a constant tug-of-war, with stagnant programs that do not meet patients’ changing needs. IQVIA can help you navigate these challenges by bringing industry best practices and data-driven actionable insights.

Act now to bridge the gap between compliance and innovation and build Patient Support Programs of tomorrow. To learn more about how IQVIA can help, click here.