Innovative services from specialty pharmacies and patient support programs
AI-translated from the Chinese original · editorially reviewed
Specialty drugs are often used to treat complex diseases such as cancer or immune disorders, so timely and continuous medication becomes critical. However, patients face cumbersome processes when using specialty drugs, and integrated pharmacy care services can significantly improve the patient experience.
Taiwan offers many self-paid specialty drug options, and physicians work to provide the best financial strategy. New cancer insurance is no longer limited to inpatient claims and allows drug purchases at specialty pharmacies. In particular, a third-party Patient Assistance Program (PAP): responsible for the transfer of information among physician, patient, insurer, and pharmacy, it shortens the time patients wait to receive their drugs. Financial assistance items should also be raised in the shared decision-making (SDM) between physician and patient, to support patients' affordability and opportunity to obtain drugs.
Although most specialty drugs in Taiwan are covered by the NHI, many specialty medications require prior-review application. From the physician submitting an application for the patient to NHI approval of the drug, the wait can sometimes exceed half a year, and uncertainty exists. This poses challenges for new patients starting new drug treatment, including the financial burden, prior authorization, and visibility of the treatment course.
On the other hand, many pharmaceutical companies offer patient assistance programs to provide free or low-cost medication options, but these programs usually require additional and cumbersome paperwork, eligibility-review steps, and compliance management, and apply only to specific patient groups.
Prior authorization is a major bottleneck in the specialty drug application process. To meet drug safety-monitoring requirements, a great deal of cumbersome paperwork is needed, greatly slowing the patient's treatment progress. Experience from US PAPs shows that more than 90% of physicians consider the prior-authorization process cumbersome and likely to cause treatment delays, and 80% of physicians say it may have a negative impact on clinical outcomes.
The solution to these problems lies in improving the visibility and interactivity of decision-making information. Through digital means, all stakeholders can be connected on the same platform, from registration and physician and patient consent to prior authorization, then to medical-benefit resource checks and financial assistance, all supervised by the compliance-management rules of the PAP, while driving automated workflows and real-time analytics. This unified ecosystem connects healthcare institutions and resource providers, patients, pharmaceutical manufacturers, specialty pharmacies, payers, foundations, and patient support program management centers. Everyone is centered on the patient, providing all the services necessary on their treatment journey, promoting information transparency and collaboration, while offering immediate assistance when problems arise.
This rigorous digital process can also reduce administrative costs and provide privacy protection, eliminating the information-exposure risks arising from traditional management by fax, letter, and telephone.
In addition, patient support management companies and specialty pharmacies can provide more sustainable services, especially for patients who need continuous testing, combination medications, or special dosage forms, which helps reduce the burden on the medical side. PATIENTSFORCE has built a new type of medication support program management platform, achieving data sharing across all stakeholders through multi-role permission management. The platform provides key management information about each patient's specialty drugs, making it easier for providers and patients to complete the complex review process and ensuring that the right drug is delivered to the right patient at the right time. At the same time, by partnering with over a hundred contracted pharmacies across Taiwan, the platform builds an alliance system of specialty pharmacies, balancing support for patient participation, affordability, and adherence, and providing patients with innovative services in financial support programs and continuous care.
Media-WIND Health Group General Manager Sean Chang
sean.chang@media-wind.com.tw