Many would agree that our inclination toward picking a career is often inspired by some form of epiphany—a realization that a said role is “meant to be.” This is true perhaps even more so in the healthcare sector, where an experience has either directly impacted a person individually, or affected a friend or loved one.
Kim Plesnarski, vice president of market access and patient services solutions at Syneos Health, has worked with the biopharma clinical and commercial solutions organization for nearly nine years, but her career in the patient access and reimbursement sector dates back beyond that.
She sat down recently with Pharma Commerce to share her muse for pursuing her passion, the formula for an effective patient support plan, and even provides a detailed list of “do’s and don’ts” when it comes to patient adherence.
This interview has been edited for length and clarity.
Q: Pharma Commerce: Your career in the patient services space alone spans more than a decade. Could you describe a “lightbulb moment” that encouraged you to pursue a position in this field?
Kim Plesnarski: For me, it was a dealing with our healthcare system as a caregiver. To sum it up, it is complicated. In-network, out-of-network, covered, covered with restrictions—it is enough to make your head spin while you are already dealing with the prohibitive cost and stress of battling an illness. I think everyone has had this shared experience. This brought me into marketing where I learned more. Once there, I understood the healthcare landscape better, and then saw it happening to patients trying to get on a brand I supported. Unbelievably, that was our biggest challenge. Once I saw this, it made me want to continue to learn more, challenge the status quo, and do what I can to make it better. Having great medicine does not mean a thing if it does not get to the people that truly need it. That is what got me into patient support and what keeps me here.
From a macro level, what challenges are companies trying to tackle when it comes to patient support growth in retail? Having a lower price point no longer mean that products are easy to access.
There are two big shifts happening right now, and our primary care providers and staff are right in the middle of it. The first is that retail products now face payer challenges like prior authorization or step edits. This means the amount of complexity and paperwork has gone up even for low-cost products. The second is specialty products/biologics are now replacing a lot of small-molecule products. There will continue to be a shift here. The impact is our primary care providers are prescribing these and are not set up to deal with the level and complexity of prior authorization, patient education on how to administer, and helping patients navigate the prohibitive cost. Manufacturers will need to be able to provide much-needed support to these patients to fill a gap. To do it, they need to think about economies of scale, efficiency, and modern engagement tactics to reach all patient types.
Q: As you know, there has been a significant rise in the number of biologics/specialty products in primary care, which means that there is a demand for patient support for services in this niche space. What advice can you offer customers, especially with healthcare providers (HCPs) often having limited time to interact with patients?
Plesnarski: You can no longer rely on a large sales force and free trials to drive demand and volume. I would say to my partners to re-think the right mix of resources and get to your root problems. In order to get things right, start with how you will create access and make it easier for patients versus focusing on driving volume at the start. The right commercial plan now must first consider market access coverage, patient support, and then a strategic sales plan that considers these market dynamics. Your patient support plan must be sustainable and scalable, and you must be thinking about how you use digital and AI tactics ethically while keeping the patient at the center. My last piece of advice is finding the right partners for technology. Being that technology is advancing and rapidly changing, it is best to partner so you can focus on strategy versus technology investment and development.
Q: What tools are necessary in order for a patient to successfully adhere to his or her medication regimen?
Plesnarski: You must address behaviors that may be preventing patients from starting or staying on the medication. This means a customized support journey that lets the patient take more ownership and shifting away from a “one-size fits-all” approach to education and support. It also means evolving your support over your brand lifecycle based on data and insights, as well as addressing the changing market and environment your patients are navigating.
Q: Looking ahead to the future, if you had to craft a patient adherence guide on “do’s and don’ts” that helps avoid past mistakes, what would you include on that list and why?
Plesnarski:
Do’s
Throw out the old way of thinking about retail. Consider what barriers prevent patients from starting and staying on a therapy, as this will help you build the optimal strategy and mix of deployed resources. Demand means nothing if your patients cannot access the medication.
Find the right partners. Technology is rapidly changing, so finding the right partner can ensure you can quickly meet the needs of your patients and engage with them the way they want and need.
Remember training and awareness. Field teams, like HCPs, are navigating more complexity. Make sure they know about your programs and how to explain them. Excellent product support does not work if there is low awareness and enrollment.
Don’ts
Create a “one-size fits-all” solution. Make sure your programs are flexible, scalable, and modern. Programs should evolve over your product lifecycle and change with data-driven insights and adapt to the current market landscape.
Forget about root cause. It may be tempting to say cost is an issue and change your copay program, but it could be that your patients simply do not know about your program due to HCPs not having time to educate or that the patients do not trust the healthcare system. Take time to understand and address access and adherence problems holistically. You may need to solve a problem at the HCP and staff level or address the patient mindset to better serve your patient population.
Over-automate or sacrifice quality. It is important to strike the right balance of technology and human touch to have an effective program and one that your patients will want to engage with. Make sure you assign and cultivate the right talent for your programs—they are the “face” of your brand.