Patient-centred innovation in our midst
October 13, 2018
While our industry still has progress to make in connecting with patients, there’s also a lot we can be proud of. Throughout the country, creative stakeholders have been working to make life easier for patients living with chronic and complex diseases. We’ve highlighted how thinking like a patient makes all the difference.
Case 1: Hospitals and community partnerships
Oral cancer therapies rely on patients to fill prescriptions, take medications as prescribed, and report side effects—but life happens. To help keep patients on track, the Southlake Regional Health Centre in Newmarket, Ont. launched a bold program with few precedents: partnering with a specialty pharmacy to support cancer patients as they transition from the hospital into community care. In the voluntary program, patients receive follow-up phone calls from an oncology pharmacist at the specialty pharmacy. The pharmacist asks questions to find out if the patient is following the regimen, experiencing any side effects and help them with their therapy.
This program illustrates how hospitals and specialty pharmacies can work together to patients’ benefit. “Delivery of drugs to patients by specialty pharmacies and coordination with community clinics is very convenient for several reasons,” says Dr. Stephanie Snow, a medical oncologist at the QEII Health Sciences Centre in Halifax. “Leveraging resources outside of the hospital is often positive for a patient’s experience. They can stay in the community instead of coming to the hospital setting and have quick access to counselling and education via their specialty pharmacy or clinic. As a physician I feel confident that my patients are receiving the utmost care as I stay in close contact with the clinic nurses and specialty pharmacists.”
Let’s put a face on it: a 56-year-old woman, on medication for metastatic breast cancer dispensed at her own pharmacy, enrolled in the Southlake program. The oncology pharmacist gave her a call and learned she was experiencing nausea, throbbing in the head, weakness in the legs. The pharmacist relayed this information to the healthcare centre, a nurse from the centre followed up to get more details, and the patient was subsequently admitted to the centre for cardiovascular management. A big win for patient care.
Case 2: Piloting home-based treatment options
There’s no place like home, especially when you’re sick— and need to take an infused medication. At the same time, home infusions have complex protocols and pose some risks, which is why infusions of specialty medications have typically been administered in the clinic or hospital setting.
Undeterred by the challenges, the manufacturer of a myeloma medication took the bold step of piloting home infusions in its PSP in the name of patient-centricity. That’s because the patients served by the drug are often very sick and may struggle to walk, let alone travel long distances to receive their medication. By removing the access barrier and bringing infusions into the home, the manufacturer achieved its overarching objective: improving the quality of life and health outcomes for patients.
There’s a financial benefit as well: by reducing hospital stays and hospital-acquired infections, home infusions save money overall for the healthcare system. Indeed, a 2017 review found home infusion to lower costs with savings between $1,900 and $2,900 per treatment course, compared to infusion in medical settings.8
The myeloma patients enrolled in the pilot program have nothing but praise for the service. In one patient’s words: “The service and explanation of the program by [my nurse] was second to none.”
Case 3: Customizing services based on individual needs
Patients living with Hepatitis in rural communities can face challenges accessing specialized care. Fortunately for patients in Prince Albert, Saskatchewan, a specialty pharmacy with expertise in hepatitis C medications has stepped up with a pioneering program that connects the patient with Shelley, a local Hep C nurse. Through a validated questionnaire, the program identifies patients at high risk of non-adherence—and supports them with customized strategies to promote treatment success.
By talking to each patient before therapy begins, the program can identify and address barriers that might otherwise slip under the radar. “The in-depth research they [the pharmacy] do on every single medication [a patient may be taking] is remarkable to me,” says Shelley, adding that “they help me facilitate the best possible care.”
Arguably most important of all, the program helps draw patients out of their isolation. Nobody explains this better than Hep C patient James: “For the past 25 years, it felt like I had nobody on my side. Since I was approved and [transferred to the program], I have so many people in my corner… I wake up and I’ve got a smile on my face. That hasn’t happened in years.”
Case 4: Innovative therapies at the local level
The best medicines do more than alleviate symptoms: they change lives. Isaiah, who has lived with atopic dermatitis (the most common form of eczema) for as long as he can remember, can attest to this reality.
While the disease often subsides with age, Isaiah’s condition kept getting worse. “My skin would shed like crazy,” recalls Isaiah, now 18, adding that simple showering caused him near-unbearable pain. Bullying from classmates, meanwhile, left him emotionally battered.
Having tried every product imaginable, to little effect, Isaiah had all but lost hope—until a breakthrough biologic medication received Canadian approval in early 2018. The medication’s PSP helped Isaiah secure coverage and assigned a nurse to support him through treatment. The PSP also enabled him and his mother, Sherry, to receive injection training at a local pharmacy. The family appreciated this convenience, which minimized their waiting time, and felt reassured that a specialty-trained pharmacist was providing the training.
After just two injections, Isaiah noticed a dramatic improvement in his disease. No longer driven to scratch his skin all the time, he even began enjoying showers. What most struck Sherry, however, was the boost in his confidence and well-being.
As Isaac’s case makes clear, innovation matters. While new policies may be putting cost pressures on the specialty drug industry, we can’t afford to sacrifice pharmaceutical innovation. Nobody knows this better than Sherry, who says: “I finally have my son back.”
References
8. Polinski JM et al. Home infusion: Safe, clinically effective, patient preferred, and cost saving. Healthc (Amst) 2017; 5:68-80.