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Pharmacists are getting increased recognition as they continue to serve on the front lines of the COVID-19 epidemic. They are innovating quickly to offer accessible healthcare, counseling, and COVID-19 resources to their local communities. Local pharmacists see more patients on a daily basis than any other healthcare provider, and that’s particularly true in the wake of COVID-19 [4]. Pharmacies play a critical role in providing patients and customers with access to care, products and services they need [3].  TV screens and other point of care tactics installed within the pharmacy educate consumers and encourage them to speak with their pharmacist, a reliable source of counseling and information for general health and wellness concerns, as well as COVID-19 [3].

Amidst the current COVID-19 crisis, we’ve witnessed the pharmacist role evolve dramatically, administering COVID-19 testing onsite, filling and extending an influx of prescriptions, and continuing to provide expert care for regular patients and customers. As consumers rushed to pharmacies to stock up on medications and purchase essential household items as other retailers were ordered to close, pharmacists worked around the clock to increase availability of supplies and ensure their patients had what they needed when they needed it. As hospitals and doctors’ offices became overwhelmed with patients, insurance companies urged patients to turn to their pharmacist as a resource [6]. Pharmacies are working hard to remain accessible, implementing CDC standards of cleanliness and social distancing within the store, while also expanding drive-through, curbside pickup and home delivery services where possible [3].

Upon issuing new guidance under the Public Readiness and Emergency Preparedness Act, authorizing licensed pharmacists to order and administer FDA-authorized COVID-19 tests, U.S. Department of Health & Human Services Secretary Alex Azar stated: “Pharmacists play a vital role in delivering convenient access to important public health services and information [2].” With nearly 90% of Americans living within five miles of a pharmacy, the local pharmacist remains appealing to healthcare consumerism beyond COVID-19 [7]. Many pharmacies offer specialty services such as blood pressure screenings, counseling on specific disease states, and medication management services [5]. Most pharmacists are also licensed to administer a wide range of vaccines and immunizations to protect against HPV, Hepatitis, Flu, and more, offering healthcare marketers a valuable opportunity to raise brand awareness at the point of care. As soon as the COVID-19 vaccine is ready, NCPA (National Community Pharmacists Association) President, Brian Caswell, expects pharmacists to be the “first in line willing to immunize their patents and help the country get back to work [4].”

References

[1] Bruce, Debra Fulghum. “What You Need to Know About Getting Vaccinated at a Pharmacy: Everyday Health.” EverydayHealth.com, 7 Oct. 2019, www.everydayhealth.com/flu/what-you-need-know-about-getting-vaccinated-pharmacy/.

[2] “HHS Statements on Authorizing Licensed Pharmacists to Order and Administer COVID-19 Tests.” HHS.gov, US Department of Health and Human Services, 8 Apr. 2020, www.hhs.gov/about/news/2020/04/08/hhs-statements-on-authorizing-licensed-pharmacists-to-order-and-administer-covid-19-tests.html.

[3] Kofman, Ava. “Pharmacy Workers Are Coming Down With COVID-19. But They Can't Afford to Stop Working.” ProPublica, 9 Apr. 2020, www.propublica.org/article/pharmacy-workers-are-coming-down-with-covid-19-but-they-cant-afford-to-stop-working.

[4] Levy, Sandra. “NCPA Campaign Highlights Independents' Commitment to Patients.” Drug Store News, 29 Apr. 2020, drugstorenews.com/ncpa-campaign-highlights-independents-commitment-patients.

[5] Longo, Kathleen Gannon. “Top Ways Pharmacists' Roles Are Changing.” Drug Topics, 22 May 2018, www.drugtopics.com/article/top-ways-pharmacists-roles-are-changing.

[6] McCook, Alison. “COVID-19: Stockpiling Refills May Strain the System.” Infectious Disease Special Edition, 11 Mar. 2020, www.idse.net/Policy–Public-Health/Article/03-20/COVID-19-Stockpiling-Refills-May-Strain-the-System/57583.

[7] “Pharmacies: A Vital Partner in Reopening America.” National Association of Chain Drug Stores (NACDS), NACDS, May 2020, www.nacds.org/pdfs/government/2020/Pharmacies-Reopening-America-COVID-19-NACDS-May2020.pdf.

When choosing a theme for this critique, I first thought about discussing the Cannes Health winners of 2020. But then, we all know what happened this year. This is the year we were all forced to rethink the role of creativity. More to the point, this unprecedented pandemic has shined a light on a long-time controversial subject—vaccines and the way we talk about them in the United States. And with so much expectation, hope, and concern swirling around an anti-Sars-Cov2 approval, people are talking about vaccines now more than ever.

I, too, decided to talk about them. I looked at the following creative examples through the lens of the experience they offer me.

After all, science's role is to be practical and exact, but our role as creatives is to make people experience something unique.

So, do I believe in it? Do I engage with it? Do I feel something?

Creative critique one

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Glaxo's Meningitis B campaigns appeal to both parents and teens, driving home critical points. The first spot shows how much can be missed if a teen is unprotected against meningitis B. The second stresses how severe the symptoms can be.

I chose these spots because they aim to hold parents or guardians accountable for what can happen if they decide not to vaccinate their children. Another reason I chose these campaigns is because I kept thinking about what I would have done differently. The tone in each spot is a bit too sad, and although I understand they are intended as a provocation, they might help unintentionally instill a fear against vaccines. If the styles were more vibrant, I think the message would come across just as well, but in a more positive manner.

Creative critique two

I like the approach for this one because of its optimistic take on what to do with risk information. Knowing what is at stake doesn't necessarily mean being afraid—that's what this spot highlights. You know what can happen, so take action to avoid it.

I also like the single-story point of view. Instead of showing the multiple “slices of life” typical in pharma, they portrayed a real young woman living her life with authenticity. The piece is also an excellent example of how cinematography, art direction, acting, and soundtrack work in harmony to deliver a smooth experience to the viewer. As a mother, I feel hopeful. As a creative director, I feel inspired.

Creative critique three

I am so close to absolutely loving this one. An HIV vaccine should be celebrated, and it feels like this is what this spot is trying to do. I appreciate the tenderness, the production value, the talent choices, the location, the light. I admire how such a short film tells such a long, poignant story.

I fall just shy of complete adoration because I would have had the couple share a gentle kiss on the mouth rather than the hand kiss at the end, just as any loving couple would do at a romantic dinner.

Creative critique four

Everything in this spot inspires hope. It's timely and timeless.

By reminding us that we turn to knowledge, research, and hard work in uncertain times, this spot instills the belief in a better future.

The production value aligns with the new normal in the world of production. Simple still shots or stock imagery tell the story. The intended message comes across with the appropriate gravitas through the thoughtful choice of the voice over.

All in, a beautiful film.

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In this interview, DTC Perspectives’ Chairman, Bob Ehrlich, and Phreesia’s SVP of Life Sciences, David Linetsky, discuss how the patient experience has evolved rapidly during the COVID-19 pandemic, particularly as providers leverage digital patient intake solutions to enable safer contactless workflows. They will also explore the importance of aligning with platforms that are flexible, adaptive, and meet patients where they are, given that these changes are likely here to stay.

Bob Ehrlich: As many are aware, the outbreak of the COVID-19 pandemic resulted in steep declines in office visit volumes in the Spring. Phreesia has since published multiple studies on outpatient visit volumes with Harvard University and the Commonwealth Fund, using Phreesia’s network data. Can you provide some insight into where these visit trends now stand?  

David Linetsky: Bob, I am happy to report that overall, patients have returned to seeking care. Most practices within the Phreesia network appear to have adapted to the pandemic and stabilized their operations. Visit volumes have remained relatively stable since June and in many cases have returned to pre-pandemic levels. In some cases, visit volumes have even exceeded their pre-pandemic levels, as many practices do active outreach to their patient populations to bring them in to catch up on deferred care.

Phreesia continues to publish this data in partnership with researchers from Harvard and the Commonwealth Fund. Our reports are released monthly and can be found on the Commonwealth Fund’s website.

Bob: I am glad to hear that levels are approaching normal. Phreesia has released several applications as a response to the pandemic across its provider network. As medical offices adjust to the “new normal”, how have these digital intake solutions helped practices get their visit volumes back to pre-pandemic levels?

David: Practices are implementing contactless workflows that help minimize exposure between patients and staff. Phreesia’s Zero-Contact Intake offering allows practices to set up alternative workflows, such as patients checking in from their cars or drive-through testing sites. In addition, practices are removing unnecessary shared spaces and assigning many of their non-provider staff members to remote work. Our COVID-19 Screening Module also automatically screens patients for self-reported COVID-19 risk factors before their visits and is continually updated based on evolving CDC guidance.

Telehealth visits have been proven to be an essential solution for patients, allowing those who don’t need to be seen in person to continue to receive care. Phreesia’s Intake for Telehealth workflow captures important intake information ahead of the visit and facilitates the start of the virtual session.

We recognized the urgent need for intake products that could support telehealth visits, screen for COVID-19 risks and minimize contact during in-person visits, and we shifted our efforts to help medical groups stay safe, stay open and continue to see patients.

Bob: Telemedicine seems to have been breaking new ground in providing a safe and efficient alternative for patients. How do you view this solution long-term?

David: We’ve heard from many of our practices that their priority is to adapt to COVID-19 by putting the safety of providers, medical staff and patients first. Prior to COVID-19, the telehealth market was dominated by specialty services offered through employee benefits plans. With the expansion of visit types qualifying for telehealth reimbursement and Medicare copays waived for telehealth visits, many of the barriers that have traditionally prevented practices from embracing virtual visits have been removed.

Data from our most recent Commonwealth Fund report show that while telehealth adoption varies significantly depending on the specialty, telehealth utilization has been relatively stable since June, at a level many times higher than pre-pandemic.

While the future of reimbursement changes—and therefore of telehealth—remains uncertain, many providers are looking towards telehealth as a creative, long-term solution to deliver patient care. From portable EKG machines to at-home ultrasounds to cancer screenings, physicians are looking for effective alternatives to traditional in-person services.

Bob: Do you see COVID-19 as the initial cause of these changes to the patient experience, or do you think some of these changes were already underway prior to the pandemic?

David: That’s a great question. While the COVID-19 outbreak accelerated the adoption of these tools among providers, it was not the initial catalyst. Prior to the pandemic, many healthcare providers had already begun to adopt digital engagement tools to manage operational, clinical and financial processes. This is a change that has been happening for many years in other industries, with consumers having come to expect the convenience of digital solutions broadly. So, safety concerns have greatly accelerated these changes in healthcare, but those changes were already underway and they will persist because consumers expect effective and convenient options.

Phreesia’s patient intake platform was designed to support these trends, which has allowed us to thrive in the current industry environment and to deliver valuable applications to our provider network and the broader market. As we navigate a new normal in a post-COVID-19 world, we believe digital engagement tools will become even more critical to ensuring that the POC stays relevant to Life Sciences manufacturers and healthcare marketers. 

Bob: With all these changes in the patient experience rapidly occurring, do you think Point of Care is still an effective channel to engage with patients?

David: Absolutely. Point of care remains a critical and incredibly valuable channel. However, to be successful, healthcare marketers must adapt to the long-term changes to the patient experience. They must understand that the point of care continues to become more ephemeral and less tied to physical locations; it’s now wherever patients choose to engage with their providers and seek care. In addition, one-to-one engagement tactics are increasingly more valuable as in-person visit volumes fluctuate because of COVID-19. Marketers should not have to worry about audience volume or quality. They should focus on tactics that ensure both of those important factors.

Some traditional tactics are quickly becoming obsolete due to providers’ concerns about shared surfaces. As technology enables patients to take an even more active role in their care, patients are increasingly receptive to personalized content tailored to their individual health needs, that can be accessed on their own devices.

Lastly, COVID-19 has caused a tremendous disruption to patients’ access to care, creating a greater need for support programs. The point of care has moved beyond the walls of the physician’s office, and I believe that the POC marketing industry must adapt.

Bob: Are there specific strategies you suggest for the Point of Care marketing industry to adapt to the increasingly digital environment?

David: I believe it is critical for healthcare marketers and life sciences manufacturers to have strategic insight into how the POC can become an integral part of their digital and mobile strategy. Patient utilization data demonstrate the value of mobile and how it enables providers to deliver care safely through contactless and virtual workflows. Personalized content and directed, one-to-one engagements cut through the noise and influx of health information and address patients’ specific needs and priorities.

Finally, incorporating disease education and patient support programs into digital engagement campaigns to ultimately improve health outcomes for target patient populations will be critical for long-term success in the changing healthcare landscape. As the patient experience becomes increasingly mediated by the converging forces of digital adaptation, patient centricity and pandemic response, we must find a way to align our digital engagement strategies at the point of care to every patient’s needs.

About David Linetsky
SVP, Life Sciences, Phreesia

David Linetsky is responsible for cultivating Phreesia’s partnerships with Life Sciences companies, supporting them in the development of healthcare products that deliver value and engage patients in their care. He has worked at Phreesia for more than a decade and held key leadership roles, including Vice President of Analytics and Insights, and Vice President of Finance.

Prior to joining Phreesia, David worked in academia as a researcher and instructor in the fields of biotechnology, mathematics and philosophy. David holds a BS in mathematics from the University of Alberta. He also earned a master’s degree and was a PhD candidate in mathematics and logic at the City University of New York.

To learn more about Phreesia, please click here or visit them on:

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After consistently seeing an underrepresentation of non-white patients in clinical research, Genentech decided to dig deeper as to why there is such enrollment inequity. According to an announcement from their website, the pharmaceutical manufacturer “undertook a landmark study to elevate the perspectives of these medically disenfranchised individuals and reveal how this long-standing inequity impacts their relationships with the healthcare system as a whole.”

Interviews with 2,207 patients were conducted to learn about their direct experiences with the healthcare system. Of the research participants, “1,001 [were] from the general population and 1,206 [were those] who qualified as ‘medically disenfranchised' from four communities: Black, Latinx, LGBTQ+, and low socioeconomic status (Low SES).” Research findings unveiled a significant lack of trust, with patients often feeling that they had been treated unequally and unfairly – or worse yet, that the system was working against them.

Genentech revealed that approximately just one-quarter to one-third of medically disenfranchised patients agree that all patients are treated fairly and equally (27% Black, 27% Latinx, 34% LGBTQ+, 23% low SES). Meanwhile, nearly half (49%) of the general population agree with that statement. Furthermore, “52% of medically disenfranchised patients believe that the healthcare system is rigged against them.”

As a result of these experiences, medically disenfranchised populations often delay, interrupt, or discontinue seeking care – often “for fear that they were not understood.” Additionally, the lack of trust has also translated to as many as one-in-three medically disenfranchised patients opting to not participate in clinical trials, vaccinations, and testing for medical conditions.

Genentech plans to continue investigating this situation further and progress their program efforts to help combat this issue. The study's announcement concluded with an inspirational message for the healthcare industry's growth and improvement by stating:

“[T]o address healthcare disparity, we must address issues of trust in the healthcare system. We must build bridges to medically disenfranchised patients to make them feel valued, respected, and understood. We must give them reasons to believe in the healthcare system.

“We know we cannot do this alone. Only through a broad coalition of industry, government, NGO, and community stakeholders will we make the changes necessary to ensure the healthcare system works for everyone. This research is the latest step in our efforts toward that goal, and we hope it serves as a call-to-action for candid discussion, proactive collaboration, and meaningful action.”

Her current work has her continuing to lead the New York medical team, managing the EU medical strategists, and also “developing solutions to address the disparity in recruitment of people of color into clinical trials.” The medical team supports both DTC and HCP new business opportunities.

“I'm thrilled to take on this new role, as this is an opportunity to elevate our diverse, best-in-class medical talent even further,” Dr. Bazuro said in the news announcement. “I look forward to ensuring best practices are uniformly implemented across all of our offices in support of our amazing clients, as they continue to bring life-changing therapies to patients in desperate need.”

Dr. Bazuro “holds a PhD in Cell and Molecular Biology from the University of Pennsylvania Medical School, a BS-Research Intensive in Cell and Molecular Biology from Yale University, and she conducted her postdoctoral research fellowship at Memorial Sloan Kettering Cancer Center.”

Today it’s more important than ever to help ensure that consumers can access and afford their medications. With the emergence of a global pandemic, what strategies and technologies can pharmaceutical manufacturers implement to help simplify and streamline the access process for consumers?

The effectiveness of a pharmaceutical manufacturer’s access and reimbursement support program will have a direct impact on patients’ ability to access and afford their medications. Here are a few examples of difficulties providers and patients have cited:

• 90% of providers [mentioned] PA-related delays in patient care and 28% reported that such delays have led to serious adverse events for patients
• Of more than 500 specialty patients surveyed, 60% claimed that they had some difficulty in receiving their first dose of specialty therapy, and 76% reported their personal role in coordinating care activities as “involved” or “very involved” (covermymeds.com Patient and Provider Surveys, 2020)
• Patients describe the time and effort required to start a specialty therapy as a full-time job – citing upwards of 30 phone calls to various healthcare stakeholders and many hours gathering information to obtain coverage (Simacek KF, et al. The impact of disease-modifying therapy access barriers on people with multiple sclerosis: mixed-methods study. J Med Internet Res. 2018;20(10):e11168)
• 60% of program enrollment forms are incorrectly completed, resulting in product access and reimbursement program delays (covermymeds.com)
• 40% of new prescriptions are not filled because of the time it takes to complete a patient’s Benefits Investigation (BI)/Benefits Verification (BV) or ePrior Authorization (ePA) (covermymeds.com)

What can pharmaceutical manufacturers do to help ensure patients can access and afford their products in an efficient manner, especially during a global pandemic? Below are six key actions and considerations:

What does the program offer, and how does it compare with others in the category and industry? What does “good” look like? How can we improve and streamline the processes? Answers to these and other questions can come through competitive program audits, market research, internal stakeholder and customer needs assessments, and audits of existing resources and enrollment forms.

Is the program visually simplified for easy recognition by patients and physicians alike? Visual complexity with misaligned branding and resources can impede program identification and equity. To achieve optimal program branding, manufacturers can apply brand values and positioning to create a compelling program name, logo, and campaign. Ultimately, brands need to develop a verbal and visual identity with style guidelines for all stakeholders to follow.

How many different resources have been created over time, and is there consistency in the message? What can we do to simplify the message and streamline the story? By following the patient access journey, manufacturers will be better informed when developing appropriate and effective online communications, including education and awareness resources, and creating or streamlining enrollment forms, reimbursement support tools, and copay and voucher resources.  This approach can also help inform virtual convention planning.

Who are all the different stakeholders and partners? Are they aligned to the common goal and working like a well-oiled machine, or are there opportunities for improvement and enhancements? Are you leveraging electronic health record (EHR) and Telehealth technology (see Figure 1) to optimize processes as well as access and affordability messaging opportunities? To find answers, manufacturers may want to perform vendor assessments, explore optimal program architecture, and seek ways to automate the BI/BV/PA processes. They may also want to explore how best to integrate software – including the EHR platforms – and aggregate data to help inform broader strategies.

Figure 1.  EHR and Telehealth access and affordability engagement opportunities

How is the program performing? Are patients getting their prescriptions filled in a timely manner? What are some of the challenges that need to be addressed? We can get answers to these questions by conducting baseline analytics to start with, defining and measuring performance metrics, integrating and analyzing data, and assessing adherence and outcomes.

How comfortable are your sales and reimbursement reps with talking about access and affordability and your program offerings? What resources can they leverage to help them successfully engage? Maybe an implementation guide can help, along with some virtual training and annotated resources and roadmaps. Do doctors and practice staff understand the full scope of your offering? Does your audience know who to reach out to? Are they aware of all the online resources available to them? Are they aware of your product’s current formulary access? How can we best communicate the access and affordability? What nonpersonal technologies can we leverage for communication and what are the optimal messages in those channels? 

In an era of virtuality and a global pandemic, all of the above become mission-critical to patient access and affordability, and ultimately, to a brand’s success. Understanding the holistic picture and how all these considerations work together will empower physicians to prescribe with confidence, patients to more easily access and afford their medications, and pharmaceutical manufacturers to maximize adoption, preference, and loyalty for their brand.