Pharmaceuticals Reward Patient Support Providers for Inefficient Call Centers

Hiding Behind Lean

Patient Support - Background

Patient support programs are focused on helping patients maneuver through bureaucratic "red tape" to help them obtain public and private insurance coverage and if necessary, lobby the pharmaceutical company for either financial co-pay or compassionate financial assistance. The objective is to get the patient on therapy as quickly as possible. Pharma companies provide this as a service free of charge to patients.

Lean

Recently, pharmaceutical companies have been promoting adoption of lean methods and going as far as boasting about their efficient call centres. A closer look however reveals either a lack of understanding of these disciplines or a lack of need to truly be efficient.

The execution of this work is typically handled in one of two ways; internally or outsourced.

Outsourcing Patient Support Programs

Pharmaceutical companies frequently outsource this work to external service providers who specialize in this type of work; typically a mix of contact centre, RN's to work with physicians and interpret patient medical history to mitigate risk of side effects, work with Dr. Offices, pharmacies, capture and report on adverse events. In short, they provide systems, people processes and "know how" that are unique for this niche market. 

The contradiction lies in how the outsource provider is paid.

FTE Headcount Invoicing
This method of payment appears to be a norm within the pharma vertical but it places the outsourced service provider in a contradictory position.

Pharmaceuticals presumably outsource this work because there is an assumption that the outsourcer will provide;

• Proven technology

• Efficient, tried & proven workflow

• "Know-how"

• A more cost effective solution than the pharma's can do themselves

• Freedom of the distraction so that pharma's can focus on their core business

Typically, that would be the rationale for outsourcing.

This pricing model however, forces the service provider to operate more like a staffing business, charging for full time headcount and then marking it up; similar to a recruiting agency. With this model, all the things one would expect from their external service provider such as investment in best of breed technology, reporting, workforce management (staffing optimization) or efficient workflow are therefore the last thing on the service provider's mind because any optimization will hurt their bottom line. In fact the very things external service providers are meant to protect their clients from such as operational inefficiencies,  backlogs, erratic service or complaints for example, are typically addressed by adding more people because that translates to more profits. Looking at the root cause is almost always avoided if possible.

That is the example of when pharmaceuticals choose to outsource to external patient support program providers. Unfortunately, the same observation holds true for those pharma's that choose to execute this work internally, only then they choose to simply ignore it. The question is why?

• They don't need the money? Each new patient on (critical) therapy medication represents approximately $100,000 of annual revenue.

• Competition is not significant enough to be a threat?

• "It's always been done this way?"

• The patient support program service is free for patients and the cost of the medication is largely subsidized by both public and private insurers (most of the time)

The reality is that the answer includes all of the above.

Tremendous Opportunity for Efficiency & Service Enhancements Sitting Dormant

So the question is why would pharmaceuticals employ strategies that run counter to realizing cost savings and service enhancements for customers/patients?

Regardless of how they execute this work, why would pharmaceuticals boast about their commitment to lean operations and efficient call centres when significant untapped opportunities for efficiency gain remain dormant?

In the pharmaceutical industry, we have observed that it is not uncommon for operators (internal and external) to not track (or ignore) what it actually costs per contact minute. This is typically the benchmark measure for any contact centre and business process outsourcer (BPO).

As lean and contact centre practitioners executing almost 80 call centre operations audits since 1996, everything we do at Tele-Centre Assist (TCA) is still premised on the very same fundamental principle that the pharma industry appears to be missing...

If you don't measure it, you can't manage it.

When benchmarked against othernon-pharma business process outsourcers, we have seen costs that are approximately half of what specialty pharma service providers charge. That represents hundreds of thousands of dollars in immediate annual savings and concurrent service enhancements for even small 20-30 seat patient support programs; as an example.

So why do pharmaceutical client organizations allow this to continue? 

We have observed that basic every day operational practices are often completely ignored, miscalculated or not understood. It is surprising to see large companies operating sometimes large call centre operations without some of the most fundamental controls, tools and processes in place. Examples of "basic every day operational practices"  that are sometimes missed include:

• Volumes by contact type

• Amount of work and contacts by type each different roles handles

• Call centre fundamentals involving workforce management (staffing optimization by time of day)

• Erlang analysis

• Call monitoring capability

• Forecasting

• Omni-channel work management  or email management

• Indexed knowledgebase for product/process/call guide information

• Dialer & campaign management technology

• Campaign management practices (outbound)

Without these very fundamental measures (and capabilities), how can you manage? How can they benchmark themselves? Why are pharmaceutical companies allowing this to continue?

The only logical answer we can arrive at is that they don't have to.

As the market changes; more bio-similars, regulatory pressures etc, pharma's will be forced to take a more serious look at both lean and efficient call centre operations.

There is a bright future for pharmaceuticals to realize cost savings while enhancing their service concurrently

In conclusion, we see significant opportunities in this vertical to deliver meaningful value to their customers/patients while saving on operating costs; money that could  be shared with end users, thus making claims of fiscal responsibility and utilization of lean and efficient call centre practices more credible in the future.

Eric Young
President
Tele-Centre Assist Inc.
www.telecentreassist.com