Navigating the hurdles of cancer treatment in India
In March 2015, Roche India launched “The Blue Tree” pan oncology patient support initiative, designed to take care of the multiple hurdles that a patient has to go through during the course of receiving treatment. The programme through a single platform enables patients to overcome these access hurdles (primarily - diagnosis, reimbursement, affordability & adherence) by providing services such as bio-marker test support, guidance on sources of funding, reimbursement documentation assistance, disease information, drug support, drug delivery at home and infusion reminder calls. The programme tele-coordinators stay in close contact with patients, helping them navigate through the different service offerings. The Blue Tree programme strives to support patients in their journey by understanding their needs and simplifying it so that they can focus on getting better and higher quality life with their loved ones. The Blue Tree provides confidence and hope and this is sometimes as important as a treatment.
In India, more than 1.3 million people develop cancer each year. Cancer is the third highest cause of mortality among NCDs (National Coverage Determinations), reflecting poor access to cancer care. While affordability (77% out-of-pocket market) is often cited as the cause of poor access, internal market assessment has established that non-price levers contribute significantly to lower access as well. For example, late diagnosis, limited and hard to-reach infrastructure are also key cancer care access challenges. Patients that do have access to treatment infrastructure are hampered by low awareness of treatment options, inadequate biomarker testing, low affordability/reimbursement of innovative therapy and poor adherence and persistence. Due to these barriers, only one out of four patients who are prescribed Roche medicines actually starts therapy. While various NGOs (non-governmental organizations) and pharma companies provide patient assistance programmes for some of these barriers, a single platform to navigate these multiple challenges was missing.
What we’re doing
Roche India designed and created “The Blue Tree” programme to be that single, differentiated, holistic cancer support programme that supports both, patients and their families through the journey of their treatment by offering services that support them to overcome key access barriers. The programme is designed to assist patients with various services ranging from diagnostics, educational material on cancer in nine different Indian local languages, identifying funding sources, assistance with documentation for reimbursement, home delivery of drugs, free medicines where possible and therapy reminder calls. Our integrated approach to patient support also empowers physicians to initiate therapy, as early as possible, ensuring delivery of optimal outcomes.
The programme services can be grouped in four broad categories:
- Disease awareness & Testing: Disease awareness material is provided to patients via the doctors in 9 languages across 5 different types of cancers. Biomarker testing support is also provided for patients who cannot afford, or do not have access to quality testing facilities.
- Funding solutions: Programme coordinators discuss less understood sources of funding including bundled health insurance, state & central government available schemes, preferential loan features of savings bank accounts, life insurance and cooperative society memberships. This information unlocks potential funding sources thus reducing the chance of a compromise in treatment choice based on affordability. If the patient is covered under one of 40+ partial reimbursement schemes, the coordinator helps them with reimbursement timelines and list of documents needed to avail reimbursement. If required, the patient is also guided to a personal loan.
- Adherence support: Programme coordinators reach out to the patient at set frequencies, especially before and after infusion cycles. Patients are additionally supported with standardized PAPs for all key products enhancing affordability and adherence. And in places where patient cannot avail drug due to unavailability of drug in remote locations, the drug purchased by patient is delivered at patient’s home.
- Customized Reports: The programme also updates prescribers with summary records & service profiles of enrolled patients.
The Blue Tree has partnered with multiple organisations such as call center, distributor, bank, logistics provider, diagnostic center & many others to make this programme a reality.
The Blue Tree programme has touched people’s lives via an integrated approach to patient support. Over the past year, more than 750 doctors have supported the programme, resulting in the enrollment of more than 3,000 patients till end of 2016. Programme statistics indicate that in 2015, 50% of patients who enquired about the programme enrolled and benefited from its services and this percentage has increased to 85% in 2016. More than 900 patients have been provided drug at no cost. An additional impact of this offering is the increasing trust and value established with physicians and the doubling of patient enrollments per month over 6 months of programme initiation.
Till end of 2016, The Blue Tree has serviced excess of 3,000 patients in more than 300 hospital/centers in India & aims to add more services like home infusion to address patient hurdles. It is a process in continuous improvement that exemplifies our commitment of “Doing now what patients need next”.