The COVID-19 pandemic has had a significant impact on the United States.  Stay-at-home orders, shuttered businesses, and furloughed workers are commonplace.  The healthcare marketplace is impacted as well; patients deferring elective procedures and hospitals trying to prepare for potential local outbreaks. For market access, the changes are felt in different ways: conferences cancelled, virtual meetings, and shifting priorities. To better understand the impact of COVID-19 on market access stakeholders, the PRECISIONvalue Access Experience Team interviewed individuals currently employed at 9 health plans, 4 pharmacy benefit managers, 6 integrated delivery networks (IDNs), and 2 specialty pharmacies. The insights found that changes, both pronounced and subtle, affect both drug access and patient health.

Perhaps most worrisome is the effect on patients with chronic care needs. Health plan respondents noted a marked decrease in claims for chronic care appointments in addition to declines in elective procedures. On the IDN side, clinic appointments besides those for acute respiratory illness, also dropped. However, patients admitted to the hospital for a non-COVID-19 condition were considerably worse than the same types of patients seen pre-COVID-19. These data indicate that, as patients cancel chronic care appointments and avoid healthcare interaction, their conditions may be worsening significantly. Payers and IDNs, unaware of this trend, may experience an increase in spending and healthcare utilization in the months ahead.

Health plans, PBMs, IDNs, and specialty pharmacies all noted a shift to reduced patient interaction and greater virtual engagement. Health plans are expanding coverage for telehealth and remote monitoring devices for certain conditions. IDNs noted exploding demand for virtual clinic visits, but conceded that not all providers were prepared to make the adjustment. Specialty pharmacies described using web video conferencing to inspect patient port and PICC sites to look for signs of infection. Furthermore, the virtual movement extends to how market access stakeholders review drugs: virtual manufacturer meetings and virtual P&T meetings.

Pharmaceutical manufacturers need to adapt to meet the needs of market access customers. Manufacturers should ensure their infrastructure and technology support virtual engagements and streamlined delivery of tactics and presentations. Additionally, access stakeholders expressed a need for information on drug supply and issues with shortages. Manufacturers can provide education on a drug’s supply chain and whether disruption can be expected. Access stakeholders also noted significantly reduced communication from the industry. The environment has changed, but manufacturers need to stay engaged and remind market access customers that manufacturers are here and available to help. To see all the results of the market research and insights from the Access Experience Team, please reach out to your PRECISIONvalue account team member.

Jeremy Schafer, PharmD, MBA
Senior Vice President, Director, Access Experience Team