Patient adherence to prescribed therapy was a persistent problem long before the COVID-19 pandemic disrupted timely diagnoses and regular health monitoring. Owing to some combination of factors that include inertia, privacy concerns, and mobility issues, an alarming percentage of patients either never start on prescribed therapy, or don't persist in following the recommended regimen. As these tendencies have been exacerbated during the global pandemic, there's a critical need to make it easy for patients to follow the treatment regimens they've been prescribed.
A remote phlebotomy service, such as IQVIA's, can be key to helping patients start, and stay on, prescription drugs for which there are requisite clinical standards that can only be determined through a blood draw and laboratory workup.
Low Levels of Adherence
The percentage of patients who never initiate prescribed therapy varies by therapeutic area and is substantial in many chronic conditions. As many as half of patients diagnosed with hyperlipidemia never fulfill their first prescription, and in HIV, that number is nearly a third (30 percent). Across a number of therapy areas, persistence on therapy drops off dramatically in the first three months and continues to decline in the first year of treatment. (See Fig. 1) Among COPD patients, for example, less than 10 percent are still on prescribed therapy 12 months after initiation.
Patient adherence to prescribed therapy is a persistent challenge:
Patient support programs help patients overcome barriers to adherence to prescribed therapy. One common hurdle in patient adherence is the need to assess and monitor lab values from blood draws. Lab workups may be necessary to determine a patient's eligibility for treatment, to establish the proper dose, or to monitor safety for therapy maintenance. Unfortunately, the need to go to a lab to have blood drawn can add to the treatment barriers that already exist for a patient. IQVIA has addressed the expanding gaps in patient adherence by extending the service offerings within its already robust patient support programs.
A Patient-Centric Approach
In-home phlebotomy services are frequently used during decentralized clinical trials and can also be easily deployed in post approval to support therapy initiation and maintenance throughout the patient journey. (See Fig. 2) Here's how a best-in-class service works:
|A Compliant Process|
|A patient support program that offers in-home blood draws in support of a specific prescription should ensure that:
• Patient enrollment is driven by a prescription (following the treatment decision)
• There is a firewall between the nurse/phlebotomist and sales roles
• The nurse/phlebotomist never discusses patient care or prescribing information
• Lab results are provided to the prescriber and via the prescriber to the patient
- The pharmaceutical company contracts with IQVIA as a provider of remote phlebotomy services, either as a standalone service, or as part of a larger PSP, and the pharmaceutical company explains the program to healthcare providers.
- The prescribing physician makes the treatment decision and subsequently enrolls the patient in the program.
- A phlebotomist is assigned to the patient based on geography and arranges a blood draw based on the patient availability.
- A certified phlebotomist visits the patient's home for the prescribed blood draw.
- Communication loops exist to provide transparency to the prescribing HCP on when the blood draw is scheduled and completed.
- The sample is sent either to the HCP or directly to a laboratory for testing. In some cases, IQVIA can facilitate the lab analysis.
- Results are communicated to the patient via the physician.
Disruptions in the patient journey caused by missed or delayed interactions with providers will impact patient outcomes and only add to the already serious issue of patient non-adherence. By filling the gaps in that patient journey through a service of in-home blood draws, pharmaceutical companies can minimize those ill effects, helping to ensure that patients receive, and stay on, the therapy their physicians prescribe. To learn more about IQVIA's remote phlebotomy services, visit IQVIA.com.