The price of prescription medications poses a significant challenge for public health. Currently, about one in four people taking prescription drugs have difficulty affording their medications, and they may respond by skipping doses or delaying filling their prescription. Other patients may cut doses in half to reduce the frequency of refills.

Medication Adherence

The costs of medical goods and services are rising, but none more than the cost of drugs - which increased by 33% from 2014 to 2020. 

While medication adherence is affected by numerous factors across the patient journey, the burden on patients around financing a prescription or treatment plan has tremendous consequences on adherence.

53% of patients have chosen not to obtain a prescription because of cost.

Preventable hospitalizations due to nonadherence account for over $100 billion a year. Not only are there monetary costs, but patients are at an increased risk for worsening conditions, co-morbid diseases, and death. 

Now that the COVID-19 pandemic has left over 3.1 million people in the U.S. without employer-sponsored insurance (ESI), the challenge of affordability is exacerbated. Even with health insurance, some patients can find themselves in the 'donut hole' - which is where Medicare beneficiaries enter a coverage gap and are responsible for 25% of the cost of medications.  

Patient Financial Assistance Programs

Whether a patient needs a one-time medication or chronic treatment, medication affordability is a widespread problem seeping into other aspects of patients’ healthcare journey. One avenue to mitigate this burden and increase patient engagement in their care journey is through patient financial assistance programs.  

While these programs offer valuable support, patients often cite that these programs are unknown or hard to locate within a pharmaceutical company's website. Beyond that, patients may require further assistance in determining their eligibility and applying (many people have insurance and believe just because they are insured, that they won’t qualify - which is not the case at all).

This journey around financial assistance is continuous, and patients need support and education on how to maintain their enrollment and provide the necessary updates to continue receiving financial support. 

Another important piece of this access puzzle is the digital literacy of the largest population of medication and care consumers.

Three-quarters of those aged 50 to 64 use prescription drugs, compared to 91 percent of those aged 80 and older. These patients tend to be on the lower end of the digital literacy scale, so navigating this process online can be challenging.  

Increase Patient Engagement

With conversational AI technology empowered by Orbita (delivered through SMS, chatbots, IVR, and beyond), pharmaceutical and life sciences companies can help patients access financial assistance program information while addressing each of these challenges along the patient care journey. Our goal is to equip pharma and life sciences with the mechanisms and strategies to guide patients to these programs and then through to successful enrollment.  

Overall, healthcare has experienced a massive realignment to support patient-centric care delivery. These new models and methods place the patient at the center with the system revolving around them. Orbita works to support pharma through this transition with frictionless, digital experiences that get patients to the information or aid that they need.  

Picture this - a patient with asthma needs financial assistance. The average cost of an inhaler is around $380 and it typically expires within one year, and if used frequently, can run out as quickly as every month. 

Patients often struggle to keep up with these costs, and for many Medicare beneficiaries, the 'donut hole' coverage gap (mentioned above) poses a serious financial challenge.

In this particular example, Orbita’s virtual assistant can alert and guide the patient to a financial assistance program either from the patient's arrival at the website or through proactive outreach. Once there, the patient can engage via voice or chat to learn about the program, go through an eligibility screener, enroll, and more.  

The barriers to a seamless care journey are so intertwined, but Orbita’s ability to tailor virtual assistants to cater to each patient's unique needs enhances the overall patient experience and reaches the patient where they are across their preferred channel.