How specialty pharma shifted gears during the pandemic – and what will change forever
July 23, 2020
Covid-19. March 2020. A time the world will remember forever. The pandemic could have spelled disaster for Canada’s specialty medicine sector—but that’s not what happened. The sector responded to the challenge with breathtaking speed and creativity, ensuring that patients continued to receive their life-saving treatments.
Flattening the fear
The news of the pandemic left many Canadians afraid. Understandably, the fear rose still higher in patients on specialty medications, many of whom live with serious chronic diseases and compromised immune systems. For many, Covid represented the classic rock-versus-hard-place dilemma: they either went to the hospital or clinic to receive care and risked exposing themselves to the virus, or they skipped the visit and risked a downturn in their existing health conditions.
In the early days of COVID, many patients chose the latter option, cancelling their appointments and hunkering down at home. Manufacturers, service providers and patient organizations knew this couldn’t go on: health outcomes depend on continuity of treatment. Without fuss or delay, these specialty stakeholders set about creating the safe environments that would bring patients back to the clinic. They modified or relocated clinics to meet the new realities of safe patient care, sped up and spaced out patient visits, and scrubbed everything down. Anticipating shortages of personal protective equipment (PPE), they sourced PPE supplies from all over the world to properly equip health professionals and patients during treatment—all within weeks.
The Canadian Cancer Survivor Network sent out newsletters to the patients it served, with straight facts about the risks of the virus to this group.1 Along similar lines, All.Can Canada (a not-for-profit organization focused on patient priorities in cancer care) partnered with the COVID-19 Oncology Patient Support Task Force to create a resource hub for cancer patients requiring help with day-to-day living, social connection, and mental health.2 Such initiatives helped patients take control of their fear and make informed decisions.
Technology to the rescue
Some treatments require in-person visits, but the sector soon learned that many operations could move to the phone or computer screen. Prior to Covid, 90 percent of physician-patient consultations took place on site.3 By April 2020, the balance had shifted dramatically, with 40 percent of consultations occurring by phone and 11 percent by video.3 These telemedicine consultations surged in virtually all therapeutic areas, from circulatory and nervous system diseases to pregnancy and postnatal health.4 High-tech medical equipment such as Bluetooth stethoscopes and apps to assess eye exams abetted the trend.3 After years of predictions that did not materialize, virtual care finally got its moment in the sun.
To support this development, the Ontario health ministry created new billing codes for telephone and video appointments.5 Turning on a dime, regulators made it possible for health providers to use such platforms such as Zoom and Skype,3 while health centres enabled patients to access their prescriptions and test results electronically.6 Many hospitals replaced in-person visits for non-urgent care with virtual consultations. Indeed, within weeks of the pandemic announcement, virtual visits represented the lion’s share of consultations at Women’s College Hospital and Unity Health in Toronto.6 Pharmaceutical representatives dove into the virtual world with equal speed and enthusiasm. While the frequency of their touchpoints with physicians declined following this shift, a survey revealed that their interactions became more substantial, lasting an average of 17 minutes instead of the previous six.7 Emails between reps and doctors also mushroomed.7
Pillars of support
Most specialty therapies include patient support programs (PSPs) to guide patients through reimbursement and treatment, and PSP providers lost no time adapting to Covid. Infusion clinics worked with medical personnel to identify patients who could follow rapid-infusion protocols or self-inject, thus minimizing person-to-person contact.8 In a remarkable show of solidarity, Canada’s PSP service providers formed a clinic working group to support patients—as well as each other—throughout the pandemic.9Novel virus, unique clinic collaboration9
When the lockdowns began, specialty medication service providers fielded daily questions from their clients: How will you provide infusions to patients? How will you keep everyone safe? How will you stay a step ahead of the pandemic? It took just a few days for four leading clinic providers—Bayshore, Coverdale, Innomar, and INVIVA—to join forces and create a national clinic working group to help each other maintain their patients on treatment—safely. The group supported each other in the development of infection control guidelines, including pre-visit screens for patients and staff. They updated their business continuity plans. When some clinics closed, leaving some patients without their “home base,” they redistributed their collective patient load so that nobody fell between the cracks.When the country locked down, millions of Canadians experienced job losses or layoffs that eroded their health benefits, which left many patients unable to afford their specialty-drug copayments and deductibles. Indeed, almost half of PSPs saw an increase in patient requests for financial assistance.10 Specialty manufacturers and PSP providers responded with a chorus of reassurance, helping patients bridge financial gaps so they could continue treatment without interruption.
Innovation in motion
In the fight against Covid, Canadian pharmaceutical innovators quickly joined the scramble to develop effective diagnostic tests, treatments, and vaccines. As early as March 12, AbCellera, a Vancouver biotechnology company, penned an agreement with Eli Lilly to develop antibody products for preventing Covid-19.11 Their raw materials? Over 500 unique antibodies isolated from an early US patient who recovered from the disease.11 Bayer Canada, meanwhile, teamed up with the Population Health Research Institute on a clinical research program focused on Covid-19 treatments.
Among Innovative Medicines Canada members, AstraZeneca ramped up its diagnostic testing capabilities and is now collaborating with governments on screening programs; Roche is offering its testing solutions to provincial public laboratories and working with governments to align their testing strategies with regional needs; not to be outdone, Sanofi is teaming up with a start-up called Luminostics to develop an over-the-counter self-testing solution.12 The list goes on.
The industry has also reached out to communities in need. At the end of April, Novartis Canada and Sandoz Canada created the Community Strong Covid-19 response program and injected it with $500,000.14 The program assists communities facing poverty, home insecurity and social isolation.14
Lasting change
As the country opens up, the national conversation is shifting to the “new normal.” So what can we expect to change, possibly forever, in Canada’s specialty medicine space?
A shift to virtual interactions, for one. With successful virtual interactions in their rear-view mirror, clinicians will continue the practice, reaching for digital tools to treat a range of medical conditions.15 Judging from a recent survey by the Canadian Medical Association, which found 91 percent of patients highly satisfied with remote care during the pandemic, patients will embrace the shift.16
The Covid crisis has also spurred the creation of worldwide data hubs,18 bringing to light the power of sharing knowledge. Insights gleaned from the data can help contain the spread of infectious disease, protect health workers, and accelerate the development of medical solutions.17 Researchers will not unlearn this lesson.
The pandemic is not over yet. Fortunately, specialty stakeholders have shown they can manage a historic crisis with extraordinary ingenuity and grace. As the Covid response strategy evolves over time, patients on specialty medications can rest assured they won’t be left behind.
At this juncture, it seems fitting to thank all stakeholders in the specialty pharmaceutical sector—manufacturers, PSP providers, and front-line workers—for their Herculean efforts to date. Patients also deserve thanks for their strength and adaptability in these strange times.
Thank you all.
References:
Canadian Cancer Survivor Network. April 2020 newsletter. https://mailchi.mp/survivornet/your-ccsn-april-2020-newsletter?e=c77e814714#COVID-19%20Additional%20Risks
Covid-19 patient support hub. https://covid19oncologyresources.ca/
Ontario Pharmaceutical Manufacturers Association Webinar. May 7, 2020. https://www.youtube.com/watch?v=Q0snxPe2hrY&feature=youtu.be
Symphony Health. COVID-19 Insight Report. Week Ending May 22, 2020.
OHIP bulletin. March 13, 2020.
Bhatia SR. Virtual healthcare is having its moment. Rules will be needed. Healthy Debate. April 8, 2020. https://healthydebate.ca/opinions/virtual-health-care-rules-covid
Bulik BS. Physicians are looking to pharma for Covid-19 comms. Where are they? Fierce Pharma. May 6, 2020.
Covid-19 update for McKesson manufacturers. April 17, 2020.
Joint letter from Bayshore Specialty Rx, Coverdale Clinics, Innomar Strategies and INVIVA to stakeholders. March 25, 2020.
Waldron & Associates. Impact of COVID-19 on Patient Support Programs Survey. April 2020.
AbCellera news release. March 12, 2020. https://www.abcellera.com/news/2020-03-abcellera-and-lilly-codevelopment
Innovative Medicines Canada. Member contributions. Updated June 10, 2020. http://innovativemedicines.ca/covid-19/member-contribution/
Bayer Canada news release. April 21, 2020. https://www.bayer.ca/en/media/news/?dt=TmpnPQ==&st=1
Novartis Canada news release. April 27, 2020. https://www.novartis.ca/en/news/media-releases/novartis-canada-initiates-community-strong-covid-19-response-program
Guthrie T. How COVID-19 Will Accelerate A Digital Therapeutics Revolution. Forbes. April 21, 2020.
Zafar A. Many Canadians used virtual medical care during COVID-19, poll suggests. CBC Health. June 8, 2020.
Torvi L. How Covid-19 will reshape our world. MaRS magazine. May 19, 2020.
Medeiros M et al. Data hubs in the fight against a global pandemic. Norton Rose Fulbright. April 7, 2020. https://www.nortonrosefulbright.com/en-ca/knowledge/publications/f5b863d9/data-hubs-in-the-fight-against-a-global-pandemic
Impact of COVID-19 on HCP practices: IQVIA market research. May 2020.
Covid-19 driving unprecedented demand. CAPDM News. https://www.capdm.ca/News/CAPDM-News/COVID-19-is-Driving-Unprecedented-Demand-(1).aspx