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Six Ways the Right Specialty Pharmacy Partner Helps Improve Medication Adherence

From missed doses to missed refills to misunderstood instructions, the reasons for patient non-adherence to therapies are lengthy and varied. For specialty therapies, additional unique barriers to adherence include the need for: prior authorization and re-authorization, assistance with high out-of-pocket costs, patient education tailored to appropriate health literacy levels, ongoing patient monitoring and reminders, regular communication with healthcare providers, and specific shipping and storage requirements. The issues can appear endlessly challenging, but specialty pharmacies are stepping up with a deep bench of support and resources.

According to a recent Pharmacy Times article:

“Independent pharmacies often provide more engaged, high-touch services in line with the culture and values of mission-driven organizations.” 1

For pharmaceutical manufacturers, partnering with the right specialty pharmacy means expert assistance in guiding patients through this most fundamental part of their treatment journey.

Below we highlight the six most essential issues and smart solutions offered by Orsini Specialty Pharmacy to improve patient adherence to vital therapies for rare diseases and complex conditions.

Issue 1: Delayed Payor Authorization. Difficulty in gaining access to specialty therapies is the first, and arguably the most important, roadblock to medication adherence. IQVIA reports a 20% increase in specialty patients not likely to fill their prescriptions over the last decade.2

Solution 1: Orsini offers deep expertise to help simplify processes and remove roadblocks to access, including:

  • Prior authorization -prepares required documentation and other essential assistance to obtain therapy coverage approval from the patient’s health plan.
  • Benefits investigation – verifies the patient’s pharmacy and medical benefits for the therapy prescribed.

Issue 2: Financial Barriers. The high cost of many specialty therapies can cause delays in receiving and refilling medications for patients.3

Solution 2: Orsini provides deep experience and expertise with:

  • Patient assistance programs – determines eligibility and customizes copay assistance programs available through foundations and manufacturers, based on the specific needs of the drug; proactively enrolls and, when needed, annually re-enrolls patients in pharmaceutical manufacturer partners copay programs. According to Patients Rising, patient assistance programs have helped more than 36 million patients in the U.S. obtain their medication in the past decade.4
  • Claims submissions – manages submitting claims to the patient’s health plan and ascertains out-of-pocket costs.

Orsini has been a strong ally in (patient) Amy՚s fight against hereditary angioedema, providing timely medication and helping her in the endless battle with insurance providers. “My rep at Orsini,” says Amy, “I know him and my other friends.” 5

Issue 3: Patient Education. Adherence is greatly enhanced when patients fully understand the benefits, proper administration, and side effects of their therapy. However, this can pose a significant challenge in terms of the low levels of health literacy in the U.S. According to the CDC, nearly nine out of 10 adults struggle to understand and use health information when it’s filled with unfamiliar or complex terms. 6

Solution 3: Orsini’s disease-specific care teams provide patients with comprehensive education from the pharmacy team at the start of therapy. The programs are developed to meet the appropriate levels of health literacy and include:

  • Details about the disease and impact of treatment
  • Potential side effects of treatment
  • Types of supplies to expect
  • How to store the drug
  • How to schedule infusions
  • Instructions for pre-medications if needed
  • Suggestions on the timing of medication depending on the administration site of care
  • Check-in call after the first infusion with family
  • Ongoing reinforcement on the benefits of therapy

Issue 4: Patient Monitoring. Sustained outreach to patients is needed to identify and manage clinical, financial, and other issues that impact specialty therapy adherence. According to the recent IQVIA Institute report focused on specialty therapies, Improving Patient Adherence and Health Outcomes:

“There is an urgent need for expanding patient support beyond addressing the specific medical issues around the disease to encompass all the aspects around emotional stress and mental health.” 7

Solution 4: Orsini has established touchpoints and protocols to help detect patient non-adherence issues promptly. These include:

  • Outreach calls from the team’s patient care coordinators, pharmacists, and nurses
  • Alerts from the nurse if a patient’s infusion date is moved or missed for any reason; Orsini team works with patient/family and nurse to make up the treatment before the next scheduled infusion date
  • Monitoring of amount of therapy in the home to address potential non-adherence issues
  • Adherence metrics are reported quarterly by patient/therapy to identify outliers or low medication adherence 

“Orsini calls me every month to make sure it’s working for me. If I don’t call them, they’ll call me.”- Wanda, tardive dyskinesia patient 8

Issue 5: Provider Communication. Keeping in contact with the patient’s provider to inform them of therapy progress and/or adverse reactions or missed doses is integral to adherence.

Solution 5: Orsini works closely with physicians to prepare for any potential issues with therapy, including complete orders for:

  • Pre-medications
  • Emergency protocols for infusion reactions
  • Emergency drug kits for home

Issue 6: Patient Reminders. The ongoing and often complex regimens of specialty therapy can mean a great deal of planning and preparation is required from the patient and their caregivers. Adherence is significantly improved with timely phone reminders, particularly by text, at critical points in the treatment plan. 9

Solution 6: Orsini’s patient outreach program includes:

  • Ongoing reminders by phone or text of the need to send additional refills and supplies, with links for easy ordering
  • Confirmation of delivery date with patient
  • Follow up with shipping vendor to ensure products and supplies arrive on time

Providing patients with comprehensive and compassionate care since 1987, Orsini is the leading independent specialty pharmacy focused on rare diseases, gene therapies, and complex conditions. Orsini’s high-touch care model centers around experienced, therapy-specific teams that provide personalized care to patients. Learn more about Orsini’s essential services for rare disease therapies and our dedicated support for manufacturers, payors, physicians, and patients.