Friday, November 03, 2023

Is Your Hub Partner Missing the Therapeutic Area Expertise You Need?

Today’s guest post comes from Greg Morris, Chief Strategy Officer at CareMetx.

Greg highlights the value of therapeutic area expertise in enhancing the performance of hub services. He explains how CareMetx's hub used its experience in the retina space to improve a new brand-name product’s launch.

To learn more about the impact of hub service on brand launch success, download CareMetx’s latest report: Patient Service Trends Point the Way to Better Hub/ Provider Partnerships.

Read on for Greg’s insights.

Is Your Hub Partner Missing the Therapeutic Area Expertise You Need?
By Greg Morris, Chief Strategy Officer, CareMetx

At CareMetx, our extensive experience in Hub services and evolving leadership in the medical benefit space have garnered us a number of critical insights. One of the most important lessons we’ve learned is the value of a Hub with therapeutic area expertise.

Below, we delve into the challenges faced by brand managers launching therapies in the retina space. The insights revealed by this retina-specific example serve as a microcosm, illustrating the impact therapeutic area expertise can have on a Hub provider’s ability to deliver value.

Three Challenges Retina Brands Face Pre-Launch

As a trusted Hub in the retina space, CareMetx regularly works alongside brand managers to introduce therapies into the market. Overall, what we’ve found is that effective brand managers launching retina products address these crucial pre-launch questions.

1. Medical Benefit Complexity

Basic Hub service methods won’t cut it in the retina space. Although the core components are foundational: benefit verification, prior authorization, copay, and patient assistance programs, providers in this space often expect an exceptionally quick and efficient benefit verification process- think seconds, not days. They need this to ensure they will get reimbursed for the treatment, because in a buy-and-bill environment (wherein the practice purchases medications for providers to administer, and then bills third-party payers for reimbursement) they’ve assumed substantial financial risk.

For a successful launch, it’s vital to find a Hub that offers well-established and reliable solutions that return results quickly, specifically for medical benefit verification; over half should be returned in less than ten seconds, with almost all returned in a day or two. It’s also important to check that the Hub is prepared to quickly scale to accommodate high-volume seasonal demands, ensuring comprehensive support for providers, and by extension to patients, each year. >

2. Complex Practice Environments

Different types of practices exist in the retina space. Many are large and well-established; others are small and have fewer resources. While the latter are often dynamic and on a growth track, they’re still less experienced in administration.

Regardless of size, retina practices typically handle high patient volumes. Physicians within these practices often see more than fifty patients per day. For that reason, efficiency is key in their operations. These are fast-paced environments where things need to be done effectively and quickly.

Large practices are savvy at navigating a Buy and Bill model and tend to have high expectations of the support they’ll receive from the therapy manufacturer. As a brand manager, this means providers will expect you to help make administrative processes easy, and to help them get reimbursed for the therapy they’ve purchased from you.

Smaller practices need more support to feel comfortable with the reimbursement risk. Often, they require more guidance on procedure codes and payer approvals. A common mistake made by manufacturers is to overlook those smaller practices’ administrative struggles. It’s a mistake that has significant downstream impact.

Effective brand managers look for a Hub that brings practical solutions—for example, tools aiding in identifying alternate injection sites, or real-time treatment confirmation—to meet the unique demands of this market segment.

3. A Need for Integration

Many providers don’t have time to toggle from interface to interface for every specialty therapy. Most retina practices want a one-stop shop where they can service every brand they prescribe.

Hub integration into both front-end (patient check-in) and back-end (scheduling and prior authorization) workflows is what makes this one-stop shop possible. Integrations enable providers to operate within a centralized location, removing the need for swiveling between multiple screens or programs.

Brand managers well prepared for a new launch ensure their Hub can seamlessly execute these integrations. Working with a Hub that can integrate core patient access solutions into providers’ existing workflows will experience a faster start in the marketplace.

To go a step further, the most effective brand managers are showing an increasing interest in Hubs that possess direct access to their own retina networks- meaning the Hub has integrations already embedded into other software used by retina practices. This strategic move is driven by the desire to tap into a broader patient base through these specialized channels.

Advanced hubs are now actively forging partnerships with established retina practice networks, bridging the gap between these networks and manufacturers. This symbiotic relationship provides manufacturers with the distinct advantage of aligning with retina providers who are already seamlessly incorporating the Hub's services into their established workflows.

Is Your Hub Partner Missing the Therapeutic Area Expertise You Need?

The insights explored in this retina-specific example underline the profound impact therapeutic area expertise can have on a Hub’s ability to deliver value.

If you want to learn more about how the right Hub can set up your brand launch for success, download our latest report: Patient Service Trends Point the Way to Better Hub/ Provider Partnerships.

Sponsored guest posts are bylined articles that are screened by Drug Channels to ensure a topical relevance to our exclusive audience. These posts do not necessarily reflect our opinions and should not be considered endorsements. To find out how you can publish a guest post on Drug Channels, please contact Paula Fein (

No comments:

Post a Comment