Access is an Outcome: Eliminating Coverage Uncertainty Across the Patient Journey

Life-changing therapies can only change lives when patients take them. By replacing manual work with Electronic Benefit Verification, life sciences leaders can eliminate health coverage confusion and help patients begin specialty medications without delay.

Innovation Begins at First Dose

Imagine a patient leaving their doctor’s office with hopes of solving a health challenge and a new specialty medication prescription. Too often, that hope can fade when faced with medication access challenges. Coverage confusion and manual processes full of phone calls and faxes can stretch time to therapy from days to weeks. For patients facing serious illness, those weeks feel like a lifetime. Hope is lost.

Life sciences companies develop therapies that can transform lives, but innovation isn’t realized when a medication is prescribed, it starts at the first dose.

Access is An Outcome

For patients, medication access means eliminating the delays and anxiety that keep them waiting. We know we measure what we value, and I believe we should measure time to therapy as closely as we measure other clinical endpoints such as blood pressure or cholesterol. Getting patients their medication quickly can improve their quality of life.

Patients Feel the Friction

The benefit verification that takes place before the patient receives their medication isn’t just a “back-end” or administrative challenge ... patients feel real friction in this process. And when reverification takes place, usually at the beginning of the year, patients must navigate new coverage terms and deductibles that reset.

Here’s what patients are up against when accessing their medication:

• 1 in 5 insured patients struggle to understand their health insurance.
• 43.1 million Americans have multiple coverages. Complexity multiplies quickly when juggling more than one health plan. In 2021, 13% of the population was doing so.
• 95% of prescribers said it should take no more than six days to get a patient started on a new therapy. In practice, however, 18% reported that it typically takes a week or more.

Quality of Life Starts with Access

With Electronic Benefit Verification, information is delivered to patient access programs in seconds. Instead of hopelessness, the patient is able to quickly start their therapy. No confusion, no delay, just access.