Asembia AXS25: Emotional Support Transforms Specialty Pharmacy Patient Care

Jen Butler, chief commercial officer at Pleio, and Mark Gregory, chief pharmacy officer at Pleio, shared during an interview with Pharmacy Times® and at Asembia's AXS25 Summit the critical role of emotional support in specialty pharmacy, highlighting how addressing patient barriers like fear, anxiety, and loneliness can significantly improve medication adherence.

Pleio and Gregory shared insights from a study revealing that 75% of patients with chronic conditions experience loneliness, which impacts their health behaviors and medication routines. The conversation emphasized the importance of peer-to-patient support programs, with 80% of patients believing such programs could improve their health management. Ultimately, Pleio and Gregory explored innovative approaches to patient care that go beyond transactional interactions, prioritizing emotional connectivity and personalized support in specialty pharmacy services.

Pharmacy Times: Why might a large increase in fills and volume only yield a small increase in adherence? What else could improve adherence?

Jen Pleio: With the program with Gentry, we clearly wanted to measure adherence and set up different measurements with PDC, with total average bills per patient and looking at engagement rate also. That's where we focused, and we were astounded with the impact that we made in those adherence measures. What we didn't expect was to see the increase in patient volume that came about in that 6-month period with the Good Start program supporting patients emotionally. We asked Gentry, well, what was going on there? Part of it is the patients are primed, if you will, with an initial call, welcoming them to the specialty pharmacy and going through the process to keep them involved in therapy, so that the volume, the sustainable volume, was increasing, with a number of patients not dropping off. Gentry was also able to bring the program to their Durham providers to let them know what was going on, which actually helped increase the fills as well. It became almost a secondary benefit that we weren't planning on, and we had great results and were continuing to do so.

Mark Gregory: I think also, not only is the patient overwhelmed in the specialty pharmacy arena, but also the pharmacy is. It's great to have a program that is very complementary to the specialty pharmacy so that they can actually work to the top of their license with their clinical assets.

Pharmacy Times: What are typical emotional barriers to specialty medication adherence, and how can pharmacy teams offer effective empathetic support?

Pleio: According to the AMA, 5 out of the top 8 reasons for non-adherence are emotional barriers. Fear being the primary driver of mistrust, misinformation, anxiety, and confusion, a lot of that is resulting in feelings of being overwhelmed when you're new to medication and new to a process. I take that, and then it becomes overwhelming on top of it. So why we're addressing the emotional barriers is because we have a very rational process that's in place, especially in pharmacies, to get patients on therapy. It's a well-orchestrated process, but what it lacks is the support and connectivity for the patient to let the patient take a breath, understand what's going on, and be supportive emotionally in that journey. That's where we come in to create a wraparound program, specialty pharmacies that are just 100% focused on the patient, allowing the conversations to take place that are not just about the transaction or a quick check-in. It's really diving into listening to the patient and letting them be heard.

Gregory: I think it's critical to recognize that the approach that we're taking is a human-first approach. The peer-to-patient relationship is critical to this whole success story.

Pleio: When we talk about emotional barriers, we talk about fear and anxiety and misinformation, but there's another emotion that is just as prevalent and not being addressed, and that's loneliness. We just fielded a study of over 2000 consumers who self-diagnose themselves with one chronic condition and with having feelings of loneliness. The results of this study are overwhelming and the impact that loneliness has on health behaviors 75% of patients reported in this study that loneliness is impacting their daily activities. It's physically affecting their condition, and 52% said that it's actually impeding their ability to maintain a medication adherence routine that skyrockets to 70% in specialty medicines. That's why the importance of having that connectivity is so important. We ask patients who they turn to. Where is the provider in this? And while patients did identify that they wanted to connect with providers, they're not always available. Family and friends are certainly a place to turn, but when they don't turn to family and friends, they go to social media, they go to WebMD. Those might not support them the same way, with the right information. We asked patients if they would be open to peer-to-patient support programs, and 80% said they thought it would actually improve their loneliness and their ability to support their health behaviors. There's hope on the horizon. We just need to think outside the box of what patient support needs to be and how to support them with that model.

Pharmacy Times: How can a pharmacy manage a significant increase in fills and patient volume while maintaining quality patient support and adherence?

Pleio: Right now, we're seeing with such advancements in technologies and medications that their volume is just increasing significantly with specialty pharmacies. It's becoming more and more transactional and trying to get more patients on fills. To scale, every pharmacy wants to be able to serve patients across the country; the strain that goes on to the technicians and the pharmacists becomes overbearing. That's why we're looking for partners who can help take some of that patient support and basically augment and supplement the patient support programs where you don't necessarily need someone with a license to do that. Then allowing pharmacists, as Mark mentioned before, to practice at the top of their license. Being able to spend the time with the patients, instead of having patients feel like they're being rushed through a call, I think is critical, but it's impossible to try to put more on pharmacies to do that.