The Changing Role of Account Managers in Specialty Pharma

Managed Markets Account Managers have been traditionally tasked with managing the payer end of pharma’s commercial business.  Yet, with more and more drugs being delivered via specialty pharmacies (SPs), many AMs have additional duties on their plates: ensuring the Rx are getting filled and reimbursed via the SPs.

Why is this?  By definition, drugs dispensed through SP’s require special handling.  This may mean refrigerated shipments, for example, or special patient support.  Many drugs have REMS (Risk Evaluation and Mitigation Strategies) requirements that regulate patient tests or other necessities that must be met prior to receiving the drug.  Some pharma companies may offer special patient services, like arranging for transportation for doctor visits, proactive refill reminders, or disease treatment advice.  Regardless, all these steps in the process can slow Rx or treatment fulfillment.  Additionally, payers may have documentation protocols of their own before approving the drug (like a prior authorization or step-edit in the system).

Obviously, the AM wants each patient to get his Rx filled in a timely manner.  The challenge when it comes to SPs, however, is that each one is unique in the way it operates – which translates into varied reports and data streams for analysis; there is not one syndicated data source (like an IMS) where one can purchase all of this data.  To complicate matters, when negotiating data contracts, sometimes companies don’t know what to ask for when it comes to data – and realize after the fact that they forgot a key data element or critical area of information.  And, data costs can be opaque with each SP, leading to cost overages.

The home office analysts receives disparate feeds (oftentimes daily) from each SP and are forced to triangulate which SP is performing well, which isn’t – and advising the AM on what to do.  Meanwhile, the AM is focused on helping the patient and pulling through those Rx.  This daily struggle can create unnecessary tension between the two teams, even though they both have the best of intentions.

Once all the data is properly organized, understood, and analyzed, however, amazing results can be achieved.  With today’s focus on outcomes and patient-centricity, AMs can get down to a level of detail previously unavailable.  With the right analytics, he can now know where each patient is in the treatment process.  He can determine if patients are awaiting reimbursement and follow-up as necessary.  If patients are awaiting REMS requirements, the AM can work with the Sales Rep to help the HCP resolve them.  Suddenly, medicine adherence can be measured as patients are tracked longitudinally over time.  And, those patients can be prompted as necessary to refill their prescription or obtain the next treatment.

A wealth of analysis is available to the AM, and not just at the patient level.  He now has the power to compare SP performance against each other and create scorecards comparing success KPIs, such as time-to-dispense and average reimbursement approval time; this can help ensure service level adherence. And, the data can be sliced by payer, so that the AM can see not only SP metrics, but payer ones as well.  In fact, if pull-through is particularly good with a payer, the AM may be able to improve contracting terms at the next appropriate negotiation juncture.  Or, if reimbursement is an issue, perhaps it’s time to train the SP on how to work with that particular payer’s systems.

While the Account Manager’s role may be changing towards a much more granular level of detail, with the right data and analytics at his fingertips, he can be much more effective to the patient and ultimately to the company.

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