Case Study: Crossing the Hospital-Alternate Site Continuum

October 30, 2012 at 10:03 AM 1 comment


Our client, a global pharmaceutical company, markets an injectable anti-coagulant.  Their concern was losing patients as they are discharged from the hospital to outpatient care, either at a nursing home or into the care of a home healthcare.  Patients would start therapy in the hospital with our client’s brand but possibly get switched to another brand of injectable anti-coagulant upon discharge.

MedSpan Research was enlisted to profile the process of care.  Based on the process of care we identified 1) key decision makers and influencers over the ordering decision in the hospital as well as at and after discharge; 2) points in the process where patients may be converted to alternative brands of anti-coagulant therapy and 3) opportunities for our client to provide support and education to encourage and then retain appropriate utilization of their therapy.

Methodology
MedSpan Research conducted in-depth telephone interviews with 45 payer executives and clinicians and administrators at a variety of care settings.   Payer executives represented commercial, Medicare and Medicaid health plans.  The clinicians and administrators represented 1) hospital-based pharmacy and case management departments, 2) specialty pharmacy pharmacists and marketing executives, 3) home healthcare administrators and directors of clinical services and 4) GPO executives responsible for contracting for pharmaceuticals. Representatives of community-based and rural hospitals as well as academic medical centers were included in the study.

Access
MedSpan Research’s RapidAccess® database contains more than 20,000 payer executives, more than 40,000 hospital executives and almost 20,000 executives representing alternate sites of care.  Through these resources and our personal relationships, MedSpan Research quickly deliver the respondents required for the study.

Expertise
MedSpan Research has developed extensive expertise in payer and hospital-based studies as well as those involving alternate sites of care.  One-half of our practice involves payer studies, one-third supports products marketed to hospitals and the remainder involves products utilized at alternate sites of care.  Our expertise with these customer segments enabled us to deliver the insights our client sought.

Results
Through the study, the client identified a number of opportunities to enhance their marketing strategy.

  • Hospital-based discharge planners are important influencers of the prescribing decision as they verify coverage for the brand of anti-coagulant the physician orders.  It is through the discharge planner’s efforts that the prescribed brand of anti-coagulant may change.
    • If coverage is disadvantageous, the discharge planner may ask the physician to prescribe an alternative brand of injectable anti-coagulant.  Typically, the discharge planner will approach the physician at the patient’s request.
    • If the patient is uninsured or otherwise does not have coverage for the prescribed brand of anti-coagulant, the discharge planner will work with the patient to submit a request to a patient assistance or charitable program.  The discharge planner may work with numerous programs, selecting the program that provides funding and, therefore, use its preferred brand of anti-coagulant.
    • If coverage is not available through a patient assistance or charitable program, the discharge planner may refer the patient to a free clinic.  The patient would receive the brand of anti-coagulant provided by the clinic.
  • Hospital-based pharmacy directors influence the brand of injectable anti-coagulant ordered in the hospital through formulary management.  This may or may not influence the brand ordered upon discharge.  If possible, many physicians prefer to maintain consistency of brand after discharge.  However, many physicians are open to switching brands if a patient’s access is advantageous for a brand that is different than the one started in the hospital.
  • Hospital-based nurses play an important role in educating patients but do not influence brand selection.
  • Payer formularies influence brand selection and the need for discharge planners to explore patient assistance and charitable programs.
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Entry filed under: Hospital Care, Nursing Home Care, Uncategorized. Tags: , , , , , , .

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