6 Patient Access Considerations for an Improved Patient Journey

For many patients, accessing the right treatment is anything but simple. Coverage restrictions, affordability challenges, and logistical barriers can create unnecessary delays, ultimately impacting health outcomes. Even the most innovative therapies can struggle with patient uptake if pharmaceutical companies fail to account for these access hurdles.

A patient-first approach to market access requires careful planning, empathy, and a deep understanding of nuances related to reimbursement, patient/HCP awareness, adherence, and more. In this article, we explore key strategies for optimizing patient access, from targeted assistance programs to the latest innovations in AI-driven support.

Contents:

What Is Patient Access?

1.  Develop A Detailed Patient Journey Map As the Foundation of an Effective Patient Access Strategy

2.  Build Targeted Patient Access Solutions

3.  Enhance Patient Education and Support for Long-Term Success

4.  Ensure Seamless Coordination Between Stakeholders

5.  Implement Site-of-Care Optimization for Faster, More Affordable Treatment

6.  Leverage Emerging Technologies to Improve Patient Access

Expert Patient Access Support from TJP

What Is Patient Access?

Patient access refers to the ability of patients to obtain the therapies and treatments they need without undue financial, administrative, or logistical barriers. It encompasses a broad range of factors, including affordability, insurance coverage, provider availability, and care coordination.

A strong patient access strategy ensures that individuals can initiate and continue treatment with minimal disruptions, ultimately leading to better health outcomes and improved adherence. For pharmaceutical brands, optimizing patient access is critical to ensuring that innovative therapies reach the patients who need them while maximizing commercial success.

1. Develop A Detailed Patient Journey Map As the Foundation of an Effective Patient Access Strategy

A successful patient access strategy starts with understanding the end-to-end patient journey, from diagnosis to treatment initiation and ongoing adherence. Without a clear map of patient obstacles, even the most well-intentioned access programs risk falling short.

In this context, research published in the Journal of Advanced Nursing concludes that “journey mapping is a rapidly growing approach for better understanding how people enter, experience and exit health services,” that has “significant potential to inform new, patient centred models of care and facilitate clinicians, patients and health professionals to better understand gaps and strategies in health services.”

An effective patient mapping process should work to understand current day-to-day patient experience, potential future-state improvements, and the operational and administrative frameworks needed to support seamless access. 

Mapping the patient journey involves breaking down each stage where patients might face financial, administrative, or logistical hurdles, including:

1. Diagnosis and treatment decisions: Delays in diagnosis, lack of provider awareness, or confusion about treatment options can prevent timely initiation.
2. Insurance and reimbursement challenges: Prior authorization requirements, high out-of-pocket costs, and formulary restrictions can slow access or lead to treatment abandonment.
3. Pharmacy barriers: Limited pharmacy availability, specialty drug requirements, or challenging logistics may make fulfillment difficult.
4. Ongoing adherence and support: Complex dosing regimens, side effects, and lack of patient education can contribute to non-adherence.

2. Build Targeted Patient Access Solutions

Patient access is not a one-size-fits-all challenge, and related interventions should be carefully targeted at distinct barriers identified in patient mapping—and at specific patient populations. For example:

• Uninsured patients may struggle with the full cost of treatment.
• Privately insured patients often encounter high deductibles, prior authorization hurdles, or coverage restrictions.
• Patients with Medicare or Medicaid may face limited formulary access or step therapy requirements that delay treatment initiation.
• Younger populations may be more likely to find information online, while older demographics may prefer traditional physical media for education and outreach.

To address these barriers, we recommend implementing customized patient access programs designed to ease financial burdens, streamline coverage processes, and improve adherence. Common patient access solutions include: 

1. Patient assistance programs (PAPs): Provide free or low-cost medications to uninsured or underinsured patients who meet financial eligibility requirements.
2. Co-pay assistance programs: Offer manufacturer reimbursement to help commercially insured patients cover some or all of their co-pays or out-of-pocket costs, thereby making treatment more affordable.
3. Benefits verification and prior authorization support: Assist providers and patients in navigating insurance requirements, expediting approval processes, and reducing time-to-therapy.

3. Enhance Patient Education and Support for Long-Term Success

Even when patients have access to treatment, lack of education and ongoing support can lead to poor adherence, early treatment discontinuation, and suboptimal outcomes. Many patients face challenges such as misunderstanding their condition, concerns about side effects, or difficulty integrating treatment into their daily routine.

A robust patient education and support framework can bridge these gaps, empowering patients to stay on therapy and achieve better health outcomes. Multichannel support programs are the best way to reach the broadest set of patients possible with impactful support that integrates resources such as:

• In-person counseling: Direct patient counseling at hospitals, pharmacies, or clinics helps address concerns, reinforce treatment benefits, and build trust with healthcare providers.
• Digital resources, including mobile apps: Patient-facing apps can offer medication tracking, educational content, symptom monitoring, and direct communication with support teams to improve adherence.
• Nurse or adherence coaching hotlines: Live support from trained professionals allows patients to ask questions, receive reassurance, and get real-time guidance on managing side effects or other treatment concerns.
• Regular reminders and motivational messaging: Automated texts, emails, or app notifications help patients stay on schedule with their medication regimen while reinforcing the importance of adherence for long-term success.

4. Ensure Seamless Coordination Between Stakeholders

Making an effective patient access strategy a reality means providing for efficient coordination between diverse stakeholders including healthcare providers, insurers, specialty pharmacies, and patient support teams. To optimize coordination, organizations should focus on:

• Integrated communication channels: Establish clear pathways for HCPs, payers, and pharmacies to share real-time updates on benefits verification, prior authorizations, and patient eligibility.
• Proactive benefits investigation and prior authorization support: Ensure support teams work closely with providers and insurers to anticipate potential coverage challenges before they disrupt access.
• Specialty pharmacy and hub services alignment: Streamline prescription fulfillment by connecting providers with specialty pharmacies early, helping patients access necessary medications faster.

5. Implement Site-of-Care Optimization for Faster, More Affordable Treatment

For patients requiring infusions, injections, or specialty therapies, the right site of care (SOC) practices can make a major difference in treatment accessibility, cost, and convenience. Without careful planning, patients may face delays, high out-of-pocket costs, or unnecessary logistical burdens.

To improve access, manufacturers should work with HCPs, specialty pharmacies, and payers to ensure patients receive treatment at the most cost-effective and clinically appropriate location, whether that’s a hospital outpatient department, a standalone treatment center, or at home. 

6. Leverage Emerging Technologies to Improve Patient Access

Technology is transforming the patient access landscape, offering new ways to streamline processes, enhance affordability, and improve long-term adherence. Some of the most impactful advancements include:

1. Predictive analytics for patient access barriers: Analytics (and increasingly, AI capabilities like machine learning) can help identify patients who may struggle with adherence due to financial constraints, logistical challenges, or insurance coverage gaps, allowing for early intervention.
2. Digital patient engagement platforms: Solutions like mobile apps and AI chatbots can provide real-time support, helping patients stay informed, complete required paperwork, and manage their treatment journey more effectively.
3. Streamlined coordination: Digital platforms can facilitate seamless communication between prescribers, pharmacies, and patient support teams, reducing delays in medication fulfillment, improving prior authorization turnaround times, and ensuring patients receive their therapies without unnecessary barriers.

Expert Patient Access Support from TJP

Navigating patient access challenges requires a strategic, patient-first approach that accounts for affordability, education, and coordination between diverse stakeholders. From mapping the patient journey to optimizing site-of-care logistics, every step plays a critical role in ensuring therapy initiation and long-term adherence.

At TJP, we specialize in patient access solutions that combine real-world insights, strategic program design, and innovative technologies that drive measurable impact. Whether you’re launching a new therapy or working to improve access to an existing treatment, our team provides the expertise and execution support needed to help patients navigate coverage complexities and receive the care they need.

Learn more about how TJP can support your patient access strategy today.