Direct-To-Patient Drug Sampling: The Benefits And Opportunities
Direct-To-Patient (“DTP”) drug sampling opens the door for streamlining the drug sample supply chain and automating regulatory compliance while supporting higher levels of patient medication adherence.
The Covid-19 pandemic is undoubtedly impacting and fast-tracking many evolutions within our healthcare system. One notable area of interest which has dramatically shifted our perception of care delivery is the rise of telemedicine. This increasingly useful way to conduct patient and physician interactions also brings other elements of care to light, namely, the possibility of Direct-to-Patient drug sampling.
If physicians can now prescribe medication via a telemedicine visit, it also makes sense to streamline the care process even further by allowing patients to receive drug samples directly to their door. The FDA is, for the first time, allowing this level of service to patients for a limited time as we continue to face the pandemic. Direct-to-Patient (“DTP”) drug sampling opens the door for streamlining the drug sample supply chain and automating regulatory compliance while supporting higher levels of patient medication adherence.
We believe that once the benefit of Direct-to- Patient drug sampling is seen during this initial phase, the demand and need for it will continue to grow, creating the real possibility for it to become a permanent offering for patients. To gain a better understanding of why this is an exciting opportunity, we will explore the benefits of drug sampling, address HIPAA requirements, and share key learnings from SymmetryRx’s prescriber survey.
The Importance of Drug Sampling
Drug samples are widely understood to:
· Provide valuable information about patient response to a new therapy
· Increase patient compliance: 30% of patients only fill an NRx when provided a sample, regardless of their age, income, or gender1
· Enable patients to initiate treatment sooner
· Increase patient satisfaction with the “care” experience2
Starting treatment sooner and saving patients money were the top answers by 197 prescribers in a recent survey of SymmetryRx’s SampleCenter™ users. That is easy to understand with 40% of Americans reporting prescription cost issues3 and the understandable patient anxiety that can come with addressing a previously undiagnosed or untreated condition.
But what is it about sampling that drives medication adherence? We can think of several reasons to explain the reality but increasingly we believe that patient/prescriber concordance – the extent to which patients and their providers agree on whether, when, and how a medication should be taken4 – happens for the 30% of patients who otherwise would not fill their prescription during the sample discussion. Direct-to-Patient drug sampling in the context of telemedicine affords a similar experience and opportunity for the patient and prescriber to engage in the subject of the patient’s well-being.
1. Datamonitor, Introduction to eSampling Solutions, Author: Not available, Published 2006
2. Physician’s Desk Reference, Summary of Findings; Current Sampling Survey, Author: Not available, Published: Not available
3. Harvard T.H. Chan School of Public Health, Four in 10 Americans say they have trouble paying for drugs or skip prescriptions or cut pills due to cost,
Author: Craig Palosky, Kaiser Family Foundation, Published 2018
4. American College of Preventative Medicine, Medication Adherence Time Tool: Improving Health Outcomes,
Author: Not available, Published 2011
Key Considerations for Direct-to-Patient Drug Sampling
Prescriber Interest in DTP Drug Sampling
Based on the responses to our Direct-to-Patient drug sampling survey from prescribers using our SampleCenter™ online sample request system, we found that there’s a great deal of interest in Direct-to-Patient drug sampling. In fact, we classify 70% of respondents as having high interest, and 30% expressed the very highest level of interest.
The survey also identified the types of samples that prescribers would consider for Direct-to-Patient drug sampling.
Types of samples prescribers are interested in
Furthermore, we found what other materials prescribers would like included in Direct-to-Patient drug sampling shipments. These materials address the educational and financial needs patients have that when met, lead to longer-term medication adherence.
Additional Materials Prescribers Want Included in DTP Shipments
Ensuring Proper Usage
An appropriate concern around Direct-to-Patient drug sampling is how physicians can ensure that the drug samples will be taken properly. In a survey conducted by SymmetryRx, we asked physicians this exact question. Respondents could select more than one answer.
· 80% would verbally describe the instructions via telemedicine visit
· 23.08% would convey the information through an online patient portal visit
· 24.62% would send instructions via email
· 7.69% would provide instructions through U.S. mail
· 13.85% responded with “Other”
These findings show that physicians have confidence in being able to communicate how to properly take a drug without needing an in-person visit.
Regulatory Due Diligence
The main obligation for Direct-to-Patient drug sampling under HIPAA is the managing and safekeeping of a patient’s Protected Health Information (PHI).
As the transaction facilitator of the Direct-to-Patient drug sampling process, SymmetryRx has the Business Associate Agreement, data security protocols, and incident detection services to meet our HIPAA obligations. Beginning with gathering PHI from prescribers through sending these details to pharma manufacturers, we use best security practices to protect this data using AWS Cloud Services and secure data transmission protocols.
Additionally, we have a thorough incident reporting protocol should someone illegally access this data. We also have appropriate systems to counteract an attempted or an actual breach, if it were to occur. Providing compliant services requires regulatory vigilance. To this end, SymmetryRx is contracting with a healthcare specialty law firm to provide Direct-to- Patient regulatory surveillance at the state and federal levels. Doing so will allow SymmetryRx to adapt to new state and federal guidelines for continued compliance in our execution.
Concerning package security, SymmetryRx will recommend best practices to pharma sample fulfillment operations from our research and the mail order pharmacy industry.
Conclusion
Drug sampling supports medication adherence. Medication adherence saves hundreds of thousands of lives and hundreds of billions of dollars. The dramatic shift of the care setting to online telemedicine requires a change in how drug samples are delivered: Direct-to-Patient. SymmetryRx has the answers to get sampled drugs where needed through a secure and HIPAA-compliant process.
Our system design requires pharma manufacturers to implement readily available/commonly used data security tools for sample request form access. In addition, SymmetryRx’s Direct-to-Patient sample request process design incorporates a 100% electronic transaction based on SymmetryRx’s innovative PDMA and 21 CFR 11 compliant eSignature process. It takes a few months to contract and set up the Direct-to-Patient service, so start today as you plan to serve prescribers and patients. Reach farther.
Misperceptions Cost Pharma Manufacturers Millions Of Dollars
Pharma manufacturers need effective solutions to target prescribers in the way in which they now prefer to request drug samples and other resources to help manage their patients. By partnering with SymmetryRx, pharma manufacturers can scale their reach to a level not possible within their own systems while also providing greater support to their existing field reps.
For pharmaceutical manufacturers, drug sampling is a key driver for familiarizing prescribers with drugs, beginning patient trials, and writing new prescriptions. Pharma manufacturers have traditionally relied on field representatives to drive the distribution of drug samples to prescribers. Though this tactic is very successful, there has been a shift in prescriber willingness or ability to meet with field reps. Between seeing patients and meeting modern documentation requirements, doctors are becoming less accessible to pharma reps. Covid-19 brings these accessibility issues to an even higher level.
Prescriber engagement strategies and relationship management tools are among the investments made by the pharma industry to address this crisis. Pharma field sales teams, while a productive part of the marketing strategy, now operate with reduced numbers while focusing on reaching accessible high prescribers. Non-personal access points such as brand and enterprise websites have replaced in-person pharma rep visits for many prescribers. This strategy offers pharma companies a convenient and economically-efficient solution for reaching prescribers.
However, going to many different websites is a non-starter for physicians, and it shows in the numbers. SymmetryRx has operated drug sample request websites at brand and enterprise levels for many manufacturers while simultaneously giving prescribers sample access through SampleCenter™, the only scalable multi-tenant, one-stop sample request site designed for prescribers.
SampleCenter™ is positioned as an “extension of the pharma rep’s reach,” allowing pharma field reps the ability to focus more on their highest skillset as a brand education and patient resource expert. It allows for the natural handoff of managing the sample request transactions for tens of thousands of eligible prescribers to SymmetryRx’s hybrid personal/non-personal sample eligibility promotion model.
Here are the numbers from our measured activity:
SymmetryRx’s hybrid promotional model delivers tremendous value in balancing prescriber needs for pharma representative educational services and day-to-day sample request transaction management. SymmetryRx brings this value to all deciles and under all practice ownership structures: Independent, Large Group, and Health Systems. Let SymmetryRx share the quantitative value of our model in the terms you use to make business decisions (i.e., Cost reduction, ROI, NPV, IRR, BE, Expense-to-Revenue, or other measures). SymmetryRx’s hybrid promotional model is a win across all metrics.
Common Misperceptions Re: Partnering With The SymmetryRX SampleCenter™
#1 Why would we partner with SymmetryRx if we already have an eSample® solution?
Whether using an internal portal or one custom-made by SymmetryRx, pharma companies may partner with us to help generate greater utilization and further reach. SampleCenterTM is currently integrated into 10 key prescriber-facing online destinations, making pharma manufacturers and their brands exponentially more visible and accessible.
Furthermore, the SymmetryRx marketing team focuses on driving targeted prescribers to these sites and presenting only relevant samples and resource offers in alignment with the business requirements of our pharma partners. As a pharma company, you have complete control over sample availability through all communication channels.
Additionally, SymmetryRx is constantly developing its platform to include the latest technology like 21 CFR 11 compliant eSignature® and HIPAA-compliant Direct-To-Patient drug sampling capabilities.
#2 We don’t want SampleCenter™ to interfere with the work of our field representatives.
For pharma companies, field reps are still a leading driver for drug sample delivery and prescriber education. Field reps rely on the management of the sample transaction to ensure the overall success of the prescriber’s engagement with the pharma company.
SampleCenter™ extends the reach of pharma reps and creates the opportunity to serve more prescribers the way they want to be served.
Here are some examples of how this partnership can be effective:
• For larger companies with a decreased number of reps, or smaller companies with an already limited number, servicing all targeted prescribers may seem impossible. SampleCenter™ fills in the gaps of non-covered prescribers in all deciles, geographies, and practice ownership structures. SampleCenter™ creates economical reach to all prescribers who value the use of samples in their practice of medicine.
• Field reps may not be able to reach or make frequent visits to all of the targeted prescribers within a specific territory. SampleCenter™ extends the reach of the field rep and pharma company to hard-to-reach prescribers and telemedicine practitioners.
• SampleCenter™ assists reps in promoting high-priority drugs and educating prescribers in their use, giving pharma reps the bandwidth needed to provide excellent levels of service.
#3 Why would we pay for sample transactions when there are minimal fees within our own system? With a revenue-to-expense ratio of close to 99 to 1, pharma manufacturers have huge incentives for utilizing both their internal platforms and SampleCenter™.
Furthermore, SymmetryRx is the single technical and marketing pharma point of contact for 10+ online prescriber destinations. The leverage provided to pharma is unbeatable, and engagement tactics are part of a pharma company’s fee. SampleCenter™ operates on a pay-for-performance structure where the pharma company only gets billed when a prescriber requests a sample of one of their products.
#4 We don’t want to spend the time auditing another drug sample vendor.
SymmetryRx is a front-end prescriber engagement and sample request generation platform. We do not manage back-end fulfillment operations. We integrate our service with your approved and contracted vendors that are responsible for processing and PDMA validation of sample requests, warehousing products, shipping, and other back-end operations. This eliminates the need for pharma companies to audit us before forming a partnership.
Due Diligence
As far as regulatory due diligence is concerned, SymmetryRx operates a validated software application that is 21 CFR part 11 compliant with a prescriber authentication process that creates a new standard in e-signature security. SymmetryRx’s new Direct-To-Patient drug sample request process is HIPAA-compliant.
Conclusion
In an ever-changing healthcare landscape, pharma manufacturers need effective solutions to target prescribers in the way in which they now prefer to request drug samples and other resources to help manage their patients. By partnering with SymmetryRx, pharma manufacturers can scale their reach to a level not possible within their own systems while also providing greater support to their existing field reps.
Our solution positions pharma brands on 10 different prescriber-facing online destinations, and our team strategically drives targeted prescribers to these online locations. With complete control over sample availability across these different communication channels, pharma companies can enjoy flexibility and efficiency with SymmetryRx’s SampleCenter™.
How Partnering With SymmetryRx Benefits Both Prescribers and Pharmaceutical Companies
SymmetryRX is incredibly aligned with the interests of pharma companies and pharma reps. We operate as an extension to what field reps are already doing and help to ensure that prescribers have the samples they need to support medication adherence and start patients on their treatments sooner.
A widely held belief among pharmaceutical companies is that in-person visits by their sales reps are the best way to issue drug samples to prescribers. This allows the sales reps to answer any questions and directly educate the prescriber about the samples. In many cases, though, prescribers simply want to replenish their sample supply and don’t have questions that would require a sales rep to be there. Thus, costing pharmaceutical companies unnecessary time and money.
Relying on in-person visits by sales reps also runs the risk of leaving prescribers without a consistent supply of samples if a rep is unable to make a visit when needed. In order for prescribers to effectively treat their patients, they need the right samples at the right time. To accomplish this, it makes sense for pharmaceutical companies to utilize an online solution that works as an extension of their sales force and allows prescribers to request samples at their convenience. Luckily, SymmetryRx has developed SampleCenter™, which addresses these issues and more.
THE BENEFITS OF WORKING WITH SAMPLECENTER™
For Prescribers
Consistent and Easy Access to Samples
When a prescriber has a patient that is a good fit for a specific drug, they need that sample on hand to get a treatment plan started as soon as possible. Through our technology and online availability, prescribers can have confidence that they will always have a steady supply of the samples they require.
SampleCenter™ is a one-stop shop for multiple brands of the drugs that prescribers need.
By accessing a single online destination, prescribers form a pattern and consistency around how they research and request samples. They don’t need to remember multiple sites or processes around receiving their samples. With our Recurring Request® feature, drug sample paperwork is automated. Prescribers are presented with completed sample request forms to be signed and returned when samples are needed. This provides practices and prescribers with complete control of their sample inventory at all times. Advanced Authentication and eSignature Capabilities Through a one-time activation that connects a prescriber to an identity verification process, we ensure that the person signing for a drug is indeed the correct prescriber. With our eSignature capability, the process for requesting samples is accelerated dramatically from having to authenticate a traditional signature. This high level of authentication is required from a PDMA perspective and brings confidence to all parties around the security of these transactions.
For Pharmaceutical Companies
Profitable Access to Every Decile
Though many pharmaceutical companies deploy sales reps into their top deciles, there are still access and timing issues for these reps. With SampleCenter™, pharma companies can ensure that these top deciles are always properly serviced in the case of access issues, while also increasing exposure and profitable transactions in their other deciles.
Increased Ability to Educate Prescribers
Some pharma companies worry that a service like SampleCenter™ will limit a sales rep’s access to prescribers and therefore reduce their ability to educate prescribers about their drugs. Education is extremely important, but for well-established brands, the educational needs are lower, and SampleCenter™ frees time for sales representatives to bring their high-level education skills to more prescribers.
Still, SymmetryRx includes educational information online for each drug for quick prescriber reference. Each brand on our site has a variety of links to pharma manufacturers’ product information, medication guides, and boxed warnings. We also have links that allow the prescriber to request a sales rep call for personal attention to their needs.
Cost Reduction
The average cost per call for a sales rep is between $200 - $240, and the rep is not always guaranteed to even see a prescriber. With SymmetryRx, the average cost per sample transaction is a fraction of the cost. It’s easy to see how pharma companies can see immediate savings by working through our portal.
SymmetryRx WORKS AS AN EXTENSION AND INDIRECT SUPPORT SYSTEM FOR FIELD REPS
SymmetryRx is in no way trying to replace sales reps; rather, our tools help them meet the transactional needs of getting drug samples into their prescribers’ hands. Sales reps provide critical educational and patient resources for the brands they support. They have very deep knowledge and access to all of the manufacturers’ resources for prescriber and patient use, which will remain highly valuable to prescribers. By utilizing SymmetryRx, sales reps can focus more of their attention on high-level activities instead of spending time supporting sample requests for which SymmetryRx provides such powerful solutions.
SymmetryRx also has a system called RadiusXP™, which allows for the remote creation and transmission of drug sample requests from pharma field reps and internal reps to their prescribers. This tool easily integrates into the manufacturers’ sample allocation system. eSignature has been added to this platform, which has made a huge difference for our current customers, especially during COVID-19.
OPTIMIZE YOUR SALES FORCE AND MEET PRESCRIBER NEEDS WITH SymmetryRx
SymmetryRx is incredibly aligned with the interests of pharma companies and pharma reps. We operate as an extension to what field reps are already doing and help to ensure that prescribers have the samples they need to support medication adherence and start patients on their treatments sooner. We are a force multiplier that pharma companies are using to generate more revenue because of our place in the supply chain of drug sampling. We are PDMA and HIPAA compliant, making us the right company to help pharma manufacturers expand and retain their business during this lower access time of COVID-19.