Readers Write: Leveraging a Digital Ecosystem to Simplify Specialty Medication Onboarding

Leveraging a Digital Ecosystem to Simplify Specialty Medication Onboarding
By Julia Regan

Julia Regan, MBA is founder and CEO of RxLightning of New Albany, IN.

Specialty medication onboarding has historically been a manual and frustrating process, riddled with complexities, administrative hurdles, and delays. However, the convergence of technology, interoperability, and a robust ecosystem of partners can revolutionize this experience, offering a glimmer of hope and path to a smoother, more efficient onboarding journey for patients.

The Complexities of Specialty Medication Onboarding

Getting a patient started on a specialty medication goes well beyond the enrollment forms. In most cases, onboarding a patient requires enrollment paperwork, benefit verification, prior authorization, financial assistance, and ongoing communication between multiple parties. The trouble is that each of these steps has typically occurred in a standalone manner, without any connection to the other steps in the process. This creates an opaque and disjointed journey for patients and providers, slowing time-to-therapy and causing avoidable administrative burden.

In addition to the process being fragmented and unclear, some parts of the journey are still completed using paper, phone, and fax – hindering transparency from the start! Whether completing the initial enrollment, approving a PA, or submitting Patient Financial Assistance forms, we are living in a world in which the system we’ve created impedes patient outcomes – instead of improving them. We must do better.

The Power of Technology and Collaborative Ecosystems

Thankfully, the advent of interoperable technology and collaborative ecosystems are beginning to bring about significant improvements to the specialty medication onboarding experience.

The first step in creating a better onboarding journey is eliminating the need for paper-based forms and communication. By leveraging fully digital portals for documentation submission and collection, we can provide immediate feedback to users about missing information, statuses, and next steps. And once digital becomes the norm, providing transparency to key stakeholders is no longer an impossibility.

The next – and arguably most important – step is developing an open ecosystem, where each participant plays a vital role in the medication onboarding journey. Each interconnected partner must be aligned in achieving a shared vision, and each plays a critical role in the final delivery and adherence of the medication. Providers and pharmacies can review and confirm coverage information, care teams can find and submit financial assistance applications, and patients can be more effectively supported by manufacturer and hub support teams.

Stakeholders should not need to log into multiple systems to manage one patient journey; instead, they should have access to one platform with all the data and integrations they need. With a truly connected ecosystem, each stakeholder can make informed decisions based on accurate and up-to-date information, ensuring the timely initiation of therapy without unnecessary hurdles.

What’s Next for Specialty Medication?

While today’s specialty medication landscape is already complex, tomorrow’s is set to become even more convoluted. At the 2023 Academy of Managed Care Pharmacy meeting, IPD Analytics shared that nearly 80% of the drugs the FDA is expected to approve in 2023 are specialty drugs, up from 68% in 2020.

How the industry navigates this wave of specialty drug approvals could significantly influence patient care. From my perspective, a transparent, interoperable system could address many of the previously mentioned challenges by streamlining communication and providing real-time access to critical information that can be used to support patient engagement, affordability, and adherence.

As specialty pharmacy continues to expand and evolve, the need for a unified, comprehensive medication onboarding ecosystem becomes increasingly important. By harnessing the power of technology, interoperability, and a collaborative ecosystem, we have the opportunity to revolutionize this space. Together, we can build a world in which every stakeholder, from the provider to the patient, is empowered to navigate the intricacies of the specialty onboarding experience.