As a former practicing physician, I know that patients can sometimes feel overwhelmed when navigating a new treatment. With multiple stakeholders on the journey to accessing a biologic drug—including patients, providers, pharmaceutical developers, payers, administrators and more—getting everyone on board with treatment goals and preferences can make the process feel much more daunting. Here are 3 things U.S. healthcare providers should consider for their patients when starting treatment with a biologic:
1. Getting to the Root of the Problem: Knowledge Is Power
While maintaining open lines of communication is critical throughout the biologic treatment journey, let’s start by looking at where the wires are most often crossed. An analysis of conversations between rheumatologists and patients published in a 2018 issue of Arthritis Care & Research shed light on where there may be significant gaps in the patient-doctor dialogue. Following discussions about initiating biologic therapy, 4 out of 10 patients were still unfamiliar with infusion biologics.i And while most rheumatologists believed inconvenience was the primary barrier for patients related to IV infusions, fewer than half of patients surveyed reported feeling this way.1
These stats point to a meaningful opportunity to improve understanding around access to professionally administered biologics such as IV treatment options among patients living with immune-mediated diseases—and address potential barriers to their care. That’s why I’m so passionate about Janssen’s commitment to examining the needs, motivations and concerns of both patients and healthcare providers to identify ways to improve communication, clear up misconceptions and empower more informed co-decision-making about optimal courses of treatment.
2. Affordability: Is Your Patient Covered?
We know there are few things more frustrating for our patients than the uncertainty of how they’ll be able to access their medicine, especially when they’re managing a progressive autoimmune disease. Before a patient initiates a biologic therapy, healthcare providers should raise issues like affordability and insurance coverage.
Exploring affordability may include the potential burden of out-of-pocket costs for patients and coverage through their insurance formulary or commercial health plan. Fortunately, infusion biologics are regulated by insurers, which means patients don’t need to rule out one mode of administration before exploring another (for example, an IV biologic can be obtained first-line with the medical benefit of a commercial insurance plan). Many pharmaceutical developers – Janssen included—also offer savings programs to assist with medication affordability for patients with private or commercial insurance. These programs commonly offer a “pay no more than $X” per refill, which discounts patients’ prescriptions usually with maximum program benefits each calendar year.
3. Exploring Accessibility: How Many Steps Must Be Taken?
In addition to affordability, we recognize that the amount of effort a patient must expend to access their preferred administration of a biologic can sometimes be difficult to understand initially – including how much time they will need to spend talking with their healthcare provider’s office, with an insurance company or a specialty pharmacy to ultimately access their medications. Healthcare providers should be prepared to talk through any administration logistics required, such as how often a patient will need to be on-site for infusions versus the frequency of self-injecting with a therapy delivered subcutaneously.
From the point when a biologic has been identified to the time a patient receives their first dose, many stakeholders play a role in treatment access, which too often results in potential barriers for patients. Ultimately, having these open conversations when a patient is about to start treatment with a biologic ensures they have all the information they need to feel empowered in making decisions about their care with their healthcare provider.
To learn more about considerations associated with the use of professionally administered biologics, check out this ReachMD segment featuring perspectives from 2 healthcare professionals on how to best help patients navigate the process and obtain the treatment they need.
i Kottak N, Tesser J, Leibowitz E, et al. Ethnographic Observational Study of the Biologic Initiation Conversation Between Rheumatologists and Biologic-Naive Rheumatoid Arthritis Patients. Arthritis Care Res (Hoboken). 2018 Jul;70(7):997-1004. doi: 10.1002/acr.23527. Epub 2018 May 28. PMID: 29381835; PMCID: PMC6033042.
