6 Critical Questions Worth Asking to Master Data in Specialty Pharma

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Selling drugs through specialty pharmacies (SPs) presents many opportunities and challenges to pharmaceutical companies. On the one hand, oftentimes the data received from each SP can be very rich. On the other hand, setting up these protocols and agreements with each SP takes time and effort. Unlike traditional Pharma, buying the Rx data from one of the large, syndicated data consolidators (such as IMS or SHA) may not be an option. Therefore, extra time and care must be taken early on, well before drug launch, to ensure you get the data you need, in a format you can work with.

Verix has extensive experience setting up and working with various specialty pharmacies. Our applications are pre-built with SP KPIs in mind. We understand the issues and opportunities around working with this data and deliver the intelligence most useful to your business. Based upon our experience, below are some key points to consider upon working with SPs.

Key Considerations:

1. How many SPs do you plan to work with? Each SP has its own unique working, contracting and pricing process. They may or may not provide the data to you in the exact structure you desire. The more SP’s you work with increases your patient access to your drug, but also increases the complexity of dealing with multiple data providers.

2. What level of data do you expect the SP to capture? Beyond the standard Rx sales information (physician and drug), are you interested in payer information, such as rejection and approval rates? Patient details and adherence to drug? Time to SP order fulfillment? Inventory level data? Knowing what you want ahead of time will make it much easier to negotiate with each SP.

3. How do you technically manage the data? Once you have the data, you may receive data feeds in different file formats, which requires a clear QA/QC process prior to loading the data in your systems. Even basic things, like numbering conventions, may differ from SP to SP. Someone needs to know all of these data nuances inside and out. With the big syndicated data vendors, for example, physician ids are included. With SPs, each has their own numbering schema and format which can lead to many errors. Fuzzy matching logic and mapping must be set-up to tie physicians across the data sets. Also, the concept of NRx and TRx must be manually calculated, as SP’s don’t automatically tell you which Rx is for a refill or a new patient. Also, care must be taken with patient level data to maintain confidentiality and meet regulatory requirements.

4. What are you going to do with the data? Once loaded, your analytics team can make good use of the data through detailed analyses that may not be possible with standard syndicated data. For example, some companies track anonymous patient level data to track new starts, refills, restarts and discontinuations. In fact, some of our clients use anonymized patient level data to track patients as they progress through the treatment process – something you can’t do with standard data feeds. Others track how long it takes the SP to get the insurer to approve (or reject) the Rx and fill the prescription. Finally, another good analysis is inventory stocking levels (and warnings for stock outages) by SP. Knowing how you plan to report on this data, building the report templates ahead of time and thinking strategically will help you early on when planning your data requirements, processing and reporting capabilities.

5. Do you track SP Performance? Once the data agreements are signed, the data are flowing and reports are being produced, you may think the hard work is over. In our experience, this isn’t necessarily the case. Whether you are getting daily or weekly feeds, there will be issues with the data that require attention and intervention to correct. Additionally, some SPs will perform better than others. One successful strategy we’ve seen is to develop an “SP Scorecard” that measures each SP on such KPIs as data accuracy, timeliness, Rx approval rates and Rx fill times. By sharing this scorecard across each of the SP’s, it allows everyone to see performance averages, goals and comparisons to the competition (with each SP being labeled anonymously). In essence, it creates a motivator for each SP to perform better. And by doing so, increases your patient service level and improves sales.

6. Are you impacting change? Everything is up and running. So, now what? Here is where the real opportunity lies in all the work you’ve completed to build this elaborate system. Understanding and acting upon your analysis can raise your drug’s success to the next level. Working in collaboration with your in-house Managed Markets, Sales and Marketing partners, you can spot trends early on and correct them. For example, we saw one SP that significantly dipped in its ability to quickly refill a prescription. Working with them to review the process’ efficiency solved the problem. Another client saw a large number of rejections of its drug with a particular SP. The Account Manager was sent in to the SP to train the team on step-edits and getting the drug approved. Finally, seeing a drop-off in continuing patients indicated to one company a need for a change in sales messaging and further market research to find the root cause of this phenomenon. Again, working with your entire Commercial team to share your findings and remove the roadblocks can lead to success.