#FutureReadyHealthcare
Buy or build? Choosing the right sourcing model for your pharma’s patient support programs
Patient support programs have emerged as powerful tools for enhancing patient care—be it fostering educational initiatives, promoting affordability, empowering patients for self-care, or improving adherence, these programs play a pivotal role in improving both patient experiences and health outcomes. Implementing such programs, however, is a complex ball game. Their success relies on effective collaboration with multiple stakeholders, such as physicians, nurses, and pharmacists. Each of these contributors plays a unique role tailored to the specific needs of patients at different junctures in their treatment journeys.
While many organizations rely on external partners to operationalize and expand these programs across diverse therapeutic areas, markets, and geographies, this approach comes with its own set of challenges.
Broken experience for patients, HCPs, and care givers
Lack of ownership of ‘high-value’ customer touchpoints
High costs
Inconsistent workflows
Data security and confidentiality risks
Disparate technologies utilized among partners
Lack of flexibility to drive innovation
Limited domain knowledge and expertise
Paucity of pre-defined metrics around program performance and success
With the view to improve customer experience, gain better control over program operations, own ‘high value’ touch points with customers, reduce costs, and drive innovation, organizations are now turning to new sourcing models. While some continue to see the benefit of a fully outsourced model, others have started adopting hybrid or entirely insourced models.
In the subsequent sections, we explore the various facets of the insourcing model to deliver high-performing patient support programs. We provide scenarios where this model would be most suited, its limitations, its impact, and guidelines for organizations to adopt this model in the near future.
Key considerations while defining a program sourcing model
When defining a program sourcing model for patient support programs, there’s no one-size-fits-all approach—it varies based on a company’s portfolio and strategic intent.
Here are some key factors that organizations should consider before establishing their sourcing model.
Need for driving seamless and unique customer experiences
External partners often provide black box standard services, making it hard for organizations to design unique customer experiences. As pharma moves toward specialty, rare disease and orphan disease segments, it is critical that patient experiences become more customized and personalized to individual needs. An insourced operation would allow pharma companies to design the requisite processes and dynamically change them as per market needs.
Cost of engagement
While insourcing may seem expensive in the short term, it can drive substantial cost savings in the long run. In contrast, costs associated with engaging external partners tend to increase over time.
Standardization
standardized program model, encompassing foundational capabilities such as technology operations, integration, data and analytics, automation, ML (machine learning), and AI (artificial intelligence) is achievable across the enterprise while allowing for front-end customer experiences customized to a specific brand or market. A well-defined workflow improves brand recognition in the marketplace and drives efficiency across core services. An insourced model gives organizations greater scope to standardize and regulate program operations vis-à-vis an outsourced model.
Consistency
Whether insourced, hybrid, or outsourced, defining a consistent and unified sourcing model can help run most elementary operations on autopilot and strengthen focus and efforts on core offerings.
Control
If ownership and transparency are primary concerns for an organization, then an insourced model, driven by in-house experts with deep domain expertise, can drive better control on program operations. This approach fosters long-term patient relationships by optimizing high-impact touchpoints.
Scalability
If an organization wants to scale its program across portfolios and geographies, then an outsourcing model driven by a partner with a global presence will facilitate scalability and improve speed to market.
Scenarios most suited to an insourcing model
Although there are several benefits and drawbacks tied to every sourcing model, the following scenarios may merit adopting an insourcing strategy to drive superior business and patient outcomes.
Complex patient journeys
Insourcing provides greater control and enables seamless coordination across multiple patient touchpoints. This is especially relevant for therapy areas where patient journeys are complex and require numerous high-value touchpoints and personalized support.
Rare diseases with a small patient population
Orphan or rare diseases affect a relatively small fraction of the population, resulting in an even smaller target patient population. However, when it comes to the success of programs catering to such diseases, the stakes are much higher as each patient is a proportionally higher contributor to the overall program performance. An insourcing model is more suited for such programs as it gives organizations better control of program operations and helps them drive significant cost savings.
Financial profile of the brand
Brands with successful track records and substantial profit margins may opt for either route depending on the nature of the program. However, brands that have the expertise and resources, building in-house capabilities could prove beneficial, particularly in achieving cost efficiencies in the long run.
Sourcing decisions can be taken at a service level instead of program-level
Based on market characteristics, distribution model, route and location of therapy administration, and drug’s clinical attributes, organizations may choose to own some services and outsource the rest. Here are some key considerations that can help organizations define their sourcing strategy at a service level.
Often outsourced services
Outsourcing offers scalability and flexibility to pharmaceutical companies. This model is suited for highly economized and process-dependent services, which may require flexible resource allocation based on project demands without investing in ancillary infrastructure or making long-term commitments. Some of the examples include:
Fulfilment
Rx triage co-pay/FTO (free-trial offer)
Travel and transportation services
Hybrid–Mostly outsourced/Can consider insourcing
While these services typically lean towards outsourcing, specific scenarios call for an insourcing model, allowing organizations to deliver more value to patients.
BI (Benefits Investigation)/BV (Benefits Verification) and PA (Prior Authorization)/Appeals: An insourcing model can utilize the best-in-class tech-driven services that easily integrate with in-house infrastructure.
Campaign management: Programs addressing orphan diseases, with little know-how around patient needs and challenges may benefit from an insourcing model.
Adherence and care plan implementation for complex diseases: The spectrum of services that can be either insourced or outsourced for adherence and care plan services is vast. Complex diseases requiring a high-touch care plan may benefit from an insourcing model, leaving more common diseases to be efficiently managed by an external partner. Hence, many companies are gravitating toward a hybrid approach.
Often insourced services
Digital enrolment/Portal: Ideal for specialty products that require the enablement of a personalized enrolment process for every new patient.
Educational activities: Insourcing educational activities can provide patients with personalized and highquality instructions.
Impact of insourcing: Increasing customer value is a driving factor
Prioritizing a beyond-the-pill approach and delivering value to customers across touchpoints stands as the paramount goal for pharma companies. And an insourcing model can enable organizations to deliver on them. From having better control over high-impact touchpoints and delivering a superior experience to enhancing program efficiency, insourcing helps organizations provide value across key stakeholders of the healthcare landscape. Moreover, it helps drive internal efficiencies due to having first-hand information about patient needs, building direct relationships with physicians and patients, and increasing responsiveness and agility of operations.
Overcoming challenges associated with insourcing
Like all other sourcing models, insourcing comes with its own set of challenges. Some of the critical ones that a manufacturer needs to be aware of include the following.
Nurturing the right talent
It is often difficult and expensive to recruit qualified specialists with the desired expertise to enable an insourcing model. It is, therefore, more cost-efficient to train current employees, equipping them to upskill and meet the new required competencies.
Striking the right balance between demand and capacity
The dynamic nature of patient support programs can cause volatility between demand and capacity requirements, resulting in poor resource allocation and cost inefficiencies. By adopting a flexible model to accommodate a sudden surge in specialist resource requirements and leveraging the predictive power of AI and forecasting models, organizations can withstand unexpected capacity modulations and avoid critical monetary and operating risks that can negatively impact program performance.
Legal and regulatory risk management
Handling large amounts of confidential data such as PHI (Protected Health Information) and PII (Personally Identifiable Information) mandates robust protective measures. Thus, when switching to an insourcing model, organizations should institute efficient safeguards, firewalls, data security measures, and robust access control to avoid data breaches, and ensure legal and regulatory compliance.
Technology investment
Technology is the cornerstone of all successful patient support initiatives. Although a dedicated focus on innovation is vital, it comes with significant cost implications, which can be hard to accommodate for brands dealing with substantial budget pressures. Evaluating program requirements in advance and onboarding a specialist technological service partner can enable organizations to service their automation needs efficiently and sustainably.
Guiding principles for adopting an insourcing model
Here are some practical recommendations to help you get started.
Learn from your peers and competitors
Peers and competitors can be your great source of learning. Organizations must analyze their competitor’s operating models, examine the design of their programs, and study their data privacy and maintenance systems to define a strong foundation for their programs.
Consider best-in-class specialist partners for outsourced services
There is no definitive right or wrong answer when defining a sourcing strategy. It all comes down to the enterprise-level strategy and product portfolio. Regardless of the model chosen, some services will still necessitate outsourcing. Organizations should focus on developing a tech-driven ecosystem that enables continual innovation. They must collaborate with best-in-class, innovative, and specialist partners with relevant domain knowledge, capabilities, and a cutting-edge technology stack to suit their needs.
Define a concrete plan to enhance strategic interactions with customers
The very essence of an insourcing model is the ability to own the strategic interactions in the patient journey. When organizations decide to go down the insourcing route, they must find the best ways to identify the high-impact interactions (patientfacing and physician-facing) in the treatment journeys. In parallel, they must also prioritize designing a robust program strategy that defines specific roles, new processes, and the need to hire and train the necessary resources to fulfil these roles.
Develop a strong communications plan and change management program
Inefficient internal adoption is the largest barrier to transforming your operating model. If organizations decide to choose an insourcing model, they must focus on creating and distributing simple communication detailing the intricacies of the model among their workforce. They must also have a robust change management plan that enables their personnel to ease into their new roles and seamlessly adopt the new way of doing things.
In conclusion
The success of effective patient support programs is anchored on three core factors—experience, efficiency, and optimization. An insourcing strategy can help pharma organizations to fill in all the voids they experience today with the traditional outsourced model. However, organizations must switch to an insourcing model at the enterprise level. Defining a best-fit sourcing model that addresses dynamic patient needs, is in line with business objectives, and is well-aligned to economic needs can bolster program performance and enable organizations to exceed expectations for a superior patient experience.
Authors
Nitin Raizada
Arindam De