Who impacts speed to therapy? That depends on who you ask

December 22, 2015

Specialty medications offer unprecedented advances in the treatment of many serious, life-threatening rare and orphan diseases. Getting patients on therapy, often described as “speed-to-therapy,” is critical for patients, drug manufacturers, and specialty pharmacies alike. When patients receive their medications quickly, they’re more likely to adhere to their treatment plans and trust particular brands long-term, both of which are directly tied to pharmaceutical company revenue. The longer it takes to fill a prescription, the more likely physicians are to seek alternate therapies for their patients. Delays in access to therapy also impact specialty pharmacies, which are often perceived as the reason for delays.

What is speed to therapy and who impacts it?

Speed to therapy measures how much time it takes for patients to receive their specialty medications. Even though speed to therapy is one of the most important metrics in the industry, manufacturers, specialty pharmacies, and hub service providers all measure and think of it differently.1

Pharmaceutical manufacturers: They care the most about speed to therapy data, but say they’re least suited to collect it.

Brand executives at pharmaceutical companies are often the ones collecting and determining speed to therapy metrics, but agree they’re least suited to provide unbiased, robust data. Rather, they believe specialty pharmacies, followed by third-party data aggregators, can more accurately collect this type of data. According to a recent study by Prometrics, most manufacturers also say hubs shouldn’t be the ones providing data on speed to therapy.2

Everyone agrees the inefficiencies are real, but manufacturers say missing information is the number one cause, followed by paper-based prior authorizations, high out-of-pocket costs, patient delays, duplicate efforts between hubs and specialty pharmacies, and finally, operational inefficiencies within the pharmacies themselves. They say better coordination with physician offices, followed by better communication with specialty pharmacies, hubs, and payers can increase speed to therapy. They also recommend a pay-for-performance model for specialty pharmacies, which could increase their incentive to fill specialty drugs more quickly.2

Specialty pharmacies: They’re on the same page with manufacturers.

According to the same study, specialty pharmacies agree with manufacturers that missing information is the biggest cause of delay. 2 After all, how often are specialty pharmacists on back-and-forth phone calls with physicians’ offices, trying to obtain lab tests and paperwork? And, how many times a day do they fax prior authorizations and patiently wait for responses?

The difference is here: specialty pharmacies say the process would be more efficient if manufacturers were better at coordinating directly with them. 2 This might include evaluating the current workflow and embracing new, more efficient technologies to better connect physicians, payers, and patients.

Hub service providers are closest to the problem — but they see the situation very differently.

The specialty medication prescribing process is complex; so complex that it gave way to hub service providers. These intermediary organizations are hired by pharmaceutical manufacturers (or built within manufacturers) to facilitate the prescription workflow and provide data insights into workflow bottlenecks.

Here’s the difference in perspective: hubs think they’re the best suited to provide accurate, unbiased analytics on speed to therapy. After, all these organizations are retained to be in the middle of the process. Secondly, hubs blame paper-based, manual prior authorizations for delays. Other studies support this line of thought; for example, it can take up to 7 days or more to complete the prior authorization process for most drugs.3

It seems all parties involved agree on the problem, but differ on its primary causes. Hubs say manufacturers should improve their coordination with them to improve speed to therapy. Yet, 45% of drug manufacturers and 64% of specialty pharmacies agree hubs actually delay the process.2 Meanwhile, hubs, who are arguably closest to the workflow, say their services, including critical patient support services and data insights, are worth any delays that might happen.

What if there is a better way — for everyone?

According to IMS Health, the specialty drug market grew nearly 27% in 2014, and in 2018, it’s predicted to make up nearly 50% of total drug costs.4 Now, more than ever, it’s critical to improve communication — and increase efficiency — among physicians, patients, payers, hubs, specialty pharmacies, and manufacturers. But how?

The solution is to automate the specialty prescribing steps, from the time of the order to delivery, in a secure and easy-to-use platform. This will modernize the prescribing process, which is currently relying on fax machines and phone calls, improve patient access to critical medications, decrease administrative burden, and improve pharmaceutical brand adoption. It’s nearly 2016. It’s time to bring everyone involved in the prescribing process together, embrace new communication technologies, and enjoy a better, faster approach.

1 Duey, Marc and Bogroff, Jason. Pharmaceutical Commerce. (February 2014).
2 Duey, Marc. “CBI-Speed to Therapy,” ProMetrics (August, 2015).
3 “Health Affairs,” Vol. 28 No. 4 w533-w543. (July/August 2009).
4 Medicine Use and Spending Shifts: A Review of the Use of Medicines in the U.S. in 2014, IMS Institute for Healthcare Informatics, April 2015