Uncategorised

To enhance patient compliance with its psoriasis drug Stelara, Janssen-Cilag tailors support to the differing needs of national markets.

To enhance patient compliance with its psoriasis drug Stelara, Janssen-Cilag tailors support to the differing needs of national markets.

Psoriasis affects nearly 2% of the population in Western countries. Although it is considered a cosmetic condition by many, it is actually a chronic, systemic inflammatory disease with significant impacts on mental health and strong co-morbidities with other chronic conditions such as obesity, type II diabetes, hypertension and cardiovascular disease. Psoriasis therefore requires maintenance therapy and presents a real patient compliance challenge, says Tom Frohlich, EMEA project manager for Janssen-Cilag.

But the concept of maintenance therapy for psoriasis is still a new one, even among many physicians, Frohlich says. And as with many other conditions requiring ongoing treatments, patients have a low understanding of the disease and the subsequent treatment. To increase the chances patients will stick with a treatment regimen, Janssen-Cilag is piloting a psoriasis support program across its European affiliates for patients taking its biologic, Stelara. Getting patients to stay compliant with Stelara, which involves an injection once every 12 weeks, is a challenge due to its high efficacy and infrequent dosing, says Frohlich. In addition, concerns about and difficulties with the use of the subcutaneous injection require strong patient support.

 We decided to create a program at the EMEA level to realize the time and cost savings that a single approach across the region can afford and to increase consistency, Frohlich explains. With huge differences in the regulatory environments across the region, we found we couldnt just put one solution in place, however. So we had to create something very flexible that met the differing needs of the various markets within the European region.

For patients, Janssen-Cilags goal is to improve outcomes. In addition, the company hopes to support physicians in patient education and monitoring, frequent feedback on patient progress, and early detection of the benefits and risks of Stelara. Janssen-Cilag also aims to increase patient and physician satisfaction and achieve a higher perceived value of its product.

The patient/physician dialogue, healthcare systems, level of nursing and patient organization support and culture vary broadly, Frohlich says. For example, pharmacists in Greece take on a significant role in patient care, unlike their counterparts in many other parts of EMEA. The Janssen-Cilag strategy capitalizes on these differences through a modular approach that puts physicians and patients in the center and allows countries to pick from a menu of choices to implement in their local area.  Available components of the program include everything from call center nurses, home nursing and educational materials to online support and flexible distribution options.

The call center nurses, provided by a third-party vendor, dispatch all other services and are therefore the pivot point of the program, Frohlich says. They support patient requests for disease and product information, provide reminder services when a dose is due, keep doctors informed of patient progress, report adverse events to the company and dispatch other resources, such as home nursing.

Home nurses, if required, visit patients in the program to assist with injection self-administration instructions and disease information as well as to return patient progress reports to the call center. Educational materials also provide self-administration instructions and disease information, along with call center contact information. Online resources include general disease awareness information, a product FAQ, personalized calendars for dosing and a self-administration video and instructions, all via a secure log-in. Where appropriate and available, flexible distribution can be coordinated by the call center to the pharmacy, a physician or the patient.

To pique physician interest, and ensure they feel they are integral part of the ongoing treatment of their patients, Janssen-Cilag offers the program through physicians as a mechanism for getting treatment information and adherence assistance to their patients. So at least initially, Frohlich says, physicians assist with enrollment of individual patients. The patient outreach process is still being evaluated, however, and may change over time.

To ensure success, Frohlich suggests companies tackling similar programs assign a project manager in each country, form a multi-disciplinary project team early in the process, develop an implementation guide for use by the various countries involved, get feedback from key customer groups, including physicians, nurses and patients, be prepared to invest timeand start earlier than you think you should.