Data, Platform, Compliance - Winning Formula for Drug Success


In the fast-paced world of pharmaceuticals, where the race for high-performance drugs is relentless, the key to success lies in reliable facts. Welcome to the era where data takes center stage, propelling drug commercialization into a new realm of possibilities. In this blog, we’ll explore how leveraging data, a powerful platform, and ensuring compliance can reshape the landscape of drug commercialization.

Unveiling the Layers of Precision With Data

High performance starts with reliable facts. For drugs covered under the medical benefit, the gold standard is national-level disaggregated patient-level claims and remittances, enriched with individualized Social Determinants of Health (SDoH). This comprehensive data should include rejection and denial reason codes, fill rates by pharmacy type, the percentage of paid, pending, and denied claims, claims reversal by pharmacy type, average days to claims resolution, and claims paid by insurer type. Such granularity is essential to dissect the conditions causing denials, providing a roadmap for improvement.

Understanding patient nonadherence requires diving even deeper into SDoH, incorporating economic security, race, ethnicity, and health literacy/education. Patient-reported SDoH or census tracks fall short in accuracy; instead, patient-level SDoH offers a nuanced understanding of access and adherence challenges. The key here is a daily data refresh, ensuring responsiveness to shifting market conditions and the most up-to-date insights.

Transformative Power of Modern Drug Commercialization Platforms

Facts alone are not enough; they need to be transformed into insights easily accessible and usable by business decision-makers. A modern drug commercialization intelligence platform is designed with curated insights and usability at its core. It offers a cost-effective, simpler, and faster path for brand managers, eliminating the need for intermediaries in the extraction and evaluation of insights.

Curating insights across the 4 A’s – Assessment, Activation, Adjudication, and Adherence – is critical for decoding provider, patient, and payer behavior. The platform provides a responsive dashboard with dynamic visualizations, enabling intuitive categorization and benchmarking of drugs. Accessibility and ease of use empower business users to find answers that affect the rate and scale of drug performance.

Systemic Compliance Monitoring in Healthcare Decisions

Utilizing reliable facts and decision intelligence necessitates a third tool: systemic compliance monitoring, especially for privacy. Compliance with HIPAA’s Privacy Rule is more challenging than ever, given the increasing diversity of patient data. Emerging state privacy regulations add another layer of complexity, demanding consistent de identification standards.

Detecting and remediating bias is crucial in today’s health equity-conscious environment. Compliance monitoring for privacy, confidentiality, and bias must be an “always on” software-based surveillance to mitigate unnecessary risks. The ability to disaggregate access and outcomes by protected class or key population subsegments is vital for a robust health equity strategy.

Last Words

Data-driven precision, transformative platforms, and unwavering compliance converge in drug commercialization is not just a possibility; it’s a reality. The integration of these elements not only enhances pharmaceutical efficiency but also contributes to a healthcare landscape prioritizing equity, innovation, and, ultimately, superior patient outcomes. In this era where data takes center stage, the power to revolutionize drug commercialization lies in our commitment to leveraging it responsibly, ethically, and with a relentless pursuit of excellence.

Posted in Healthcare