Year: 2024

7th March, 2024

Digital technologies have brought in a new wave of innovation to healthcare, transforming the way in which patients access medical services, professionals deliver care, and organizations operate.  

As a pioneer in access to healthcare solutions for over 25 years, Axios International has embraced this transformative wave through Axios+, a comprehensive and integrated digital health ecosystem committed to providing digital accessibility while maintaining a human approach.  

Leveraging data to empower decision-making

Axios+ is more than just a technological advancement. Axios+ enables pharmacists, doctors, laboratories, and various other entities to make quality healthcare accessible to patients, regardless of their location or economic status, and supports patients throughout their treatment journey.  

Interconnectivity is key to providing multi-dimensional support to patients and has proven to have multiple operational benefits for patients and all the parties involved. So, from simplifying the support program introduction of patients for physicians to aiding pharmaceutical companies in monitoring, Axios+ positions itself as an integrated patient-centric technology.  

Axios+ already makes it easier for patients to schedule deliveries, contact our program teams, and report adverse events. As an organization, Axios plans to adopt Artificial Intelligence (AI) in the near future, which will improve productivity and efficiency, smoothen operations, and ultimately improve the handling of patient services.  

For example, AI algorithms can analyze large datasets to identify patterns and trends, aiding disease prevention and early diagnosis, allowing us to collect, view, understand, and process data to make better-informed decisions. Additionally, by utilizing AI tools alongside our Patient Management System, we can further improve data accuracy and consistency, eventually leading to enhanced personalization of our digital tools and predictive models.  

Empowering and enabling patients to receive quality care and treatment

One standout area of the Axios + ecosystem is the MyHealth app, which serves to empower patients. Specifically designed for patients, it sends timely medication reminders, assists in obtaining required medications, and streamlines the entire patient support experience through automated processes. This maximizes treatment adherence and contributes to patients’ overall well-being. As a result, Axios+ patients are better equipped to take control of their treatment by ensuring they have easy access to relevant and timely information. 

At the core of the system is MyHealth, which provides a very practical approach that ensures patients stay on treatment. However, there is still space for AI in this instance without losing the human touch. But that’s just one arm of Axios +, so what does the full ecosystem entail?  

Holistic, customized, and sustainable digital access solutions

• MyPatients for Physicians 
  Available on mobile and desktop, the MyPatients application offers a simple process for registering patients to Axios-managed Patient Support Programs (PSPs). It also helps physicians easily refer patients, upload documents or sign them digitally, and track their progress in the program in real-time.  
  
  
• MyHealth for Patients
  Available on mobile, the MyHealth application gives patients a robust platform to track their treatment regimens and adhere to treatment plans easily. Accessing in-app functionalities, such as viewing medical releases and uploading relevant documents for a comprehensive treatment history, becomes available to patients once they are enrolled in the programs managed by Axios International. They can also view upcoming medical releases and easily obtain their medication from a partnered pharmacy.  
  
  
• MyPharmacy for Pharmacists
  Available on mobile and desktop, MyPharmacy is uniquely developed for pharmacists and pharmacies registered in Axios-managed Access programs. The application enables pharmacists to schedule the release of upcoming prescriptions for each patient and validate any documents they receive using an integrated QR code scanner or security code. In addition to addressing the core needs of patients, doctors, and pharmacists, Axios+ has features that contribute to the overall success of treatment programs.  
  
  
• MyPrograms Dashboard
  Available on desktop, The MyPrograms dashboard allows pharmaceutical companies that are part of the PSPs to view live data on their treatment successes and failures. It simplifies and combines data related to the program to provide a comprehensive overview of up-to-date aggregated and anonymized data. They can view the number of patients by status in the program, track the number of physicians or hospitals referring patients to the program, and view product distribution by commercial type or the number of units.   
  
  
• MyCharity feature
  Available on desktop, MyCharity is a simplified platform that allows charities to track and manage patient charity applications associated with Axios-managed PSPs, fostering a collaborative approach to healthcare. The platform’s success lies in its technological prowess and commitment to a patient-centric approach, creating a more informed, accurate, and accessible foundation for developing, improving, and administering treatments.   
  
  

Axios+, empowering the present, enabling the future

The future of the digital landscape is certainly exciting. Axios+ presently offers an innovative collection of user-friendly digital solutions tailored to different stakeholders. It lays the foundation for leveraging both current and emerging technologies to ensure access to the highest level of care and support for all our patients.   

5th February, 2024

Table of Contents

When Axios International started operations 25 years ago, the focus was on addressing financial barriers that stopped patients from obtaining necessary treatment. Over the course of Axios’ journey in the field of healthcare accessibility, gathered insights showed that beyond affordability, various other barriers throughout the patient journey stopped them from achieving optimal medical outcomes.  

As Axios grew and learned from experience, research, and real-world insights, the complexities beyond affordability were explored to enhance the patient’s journey. Questions including: What can we learn from the Patient Access Programs we designed and managed? How can we keep improving them while looking at factors influencing the patient’s journey? were asked. 

The patient journey: Beyond affordability 

While affordability remains a critical barrier, it is just one facet of the intricate patient journey. Over time, a holistic approach has emerged, and we acknowledge the need to sophisticate strategies and interventions to ensure optimal medical outcomes. The patient journey – depicted as a sequence from disease onset to treatment adherence – also encompasses various stages, such as diagnosis, prescription, compliance, and adherence, which we think is a given. Notably, the complexities intensify outside the hospital setting, particularly in chronic and long-term treatment scenarios, necessitating improvements at every step. 

Understanding influencing factors: A case study 

One pivotal realization in understanding access was that addressing affordability alone did not guarantee success. We had extremely generous programs, but even then, we did not have patients because the doctors didn’t refer them, or sometimes the patients refused to take the treatment when they were referred.  

Despite having a prescription and an affordable program for the patient, we noted that it was unsuccessful. So, what other factors blocked or sometimes facilitated the patient’s outcome? Where was the hiccup? 

We conducted a multi-country, in-depth study with patients and physicians to research willingness to pay and willingness to prescribe and assess why the access programs were unsuccessful. We gave physicians different price ranges and found that at a certain price, regardless of whether you have a program or not, regardless of whether the patient is willing to pay or can afford it or not, physicians will not prescribe because they do not see the value for the patient in getting treated. –

Validating our findings, a case study on asthma patients also showed that perceived value played a crucial role in physician prescription decisions beyond affordability. The study identified a price threshold below which physicians were reluctant to prescribe because they did not perceive the value, emphasizing the necessity to address value perception or value pricing before implementing access programs. 

Tailoring solutions to regional dynamics 

Regional disparities in patient mindset further underscored the need for tailored solutions. For example, a comparative analysis between India and Egypt for asthma treatment highlighted the influence of regional economic factors. In India, patients were unwilling to pay at higher price points even if they could afford it, whereas, in Egypt, a higher cost of asthma treatment influenced both physicians and patients positively.  

This was an eye-opener for us.  

Axios access experts learned not to rush into designing access programs without understanding the physicians’ and patients’ mindset for that disease. These Real-World Insights prompted a re-evaluation of the one-size-fits-all approach, emphasizing the importance of understanding regional specificities before implementing access programs. 

Financial assessment tools: Evolving precision 

Financial assessment tools like Axios’ proprietary Patient Financial Assessment Tool (PFET) are crucial to determining patients’ ability to pay so they can complete the full course of treatment and get the best medical outcomes.  

Since 2006, the tool has been continuously refined as well as validated and published in journals such as Population Health Management and the Journal of Comparative Effectiveness Research. However, despite the presence of a validated tool, there was a need to understand the parameters for accurate financial assessment and what factors influence the patients. 

A study titled: Ability to pay for medication: a cluster analysis of 1404 patients with the Patient Financial Eligibility Tool, examining three countries – Thailand, the United Arab Emirates, and Mexico – was carried out to explore parameters influencing accurate financial assessments. By incorporating income, assets, and standard of living, the tool demonstrated flexibility in addressing diverse economic landscapes, especially in informal economies. It also showed that the standard of living and income are the biggest drivers. Following the outcomes of these studies, assessments were done to understand the country-specificities and improve the tool to overcome some of these barriers.  

Real World Insights: Why adherence matters 

Research done to assess the impact of access programs on patient adherence revealed significant improvements in treatment duration, demonstrating an increased patient adherence from 226 to 465 days on average. These findings emphasized the pivotal role of access programs in enhancing medical outcomes.  

Pharmacists’ Role: A critical insight 

In the pursuit of understanding healthcare providers’ roles, another study done by Axios International acknowledged the often-overlooked significance of pharmacists. The research done in Egypt on Chronic Obstructive Pulmonary Disease (COPD) treatment highlighted that contrary to physicians with a high patient load, smaller pharmacies demonstrated superior patient outcomes. The study also found that small pharmacies serving the community and dealing with fewer patients had a statistically significant better outcome in Egypt compared to pharmacies with many patients. This emphasized the importance of pharmacist-patient interaction, suggesting tailored strategies based on the scale of healthcare providers. A similar study in Lebanon on oncology treatment showed the reverse. Bigger pharmacies handling many patients had statistically significant better adherence and fewer dropouts than smaller pharmacies when it came to oncology treatment because specialized treatment required specific knowledge and expertise.  

Impact of economic crisis on medical outcomes 

A key barrier that must be considered while designing an access program is the economic barrier. 

To illustrate this point and as an example, the unforeseen impact of economic crises on patient outcomes was illuminated through an analysis of Lebanon’s economic downturn since 2019. Patients undergoing cancer treatment experienced a significant decline in survival rates post-crisis, indicating the interplay between economic factors and healthcare system support. While beyond direct influence, such findings underscored the importance of considering external economic factors in patient access strategies. Therefore, the impact of the economic crisis on the medical outcome is an important factor to consider because it shows that economic factors cannot be influenced. 

Quest for access: An enduring and dynamic journey 

The journey of providing access to healthcare is evolving, demanding constant improvement and adaptation. The intricate landscape of patient access is changing, emphasizing the need for comprehensive understanding, continuous questioning, and progressive research to overcome barriers. Axios International’s commitment to optimizing patient outcomes remains unwavering as the healthcare landscape develops, making the quest for access an enduring and dynamic journey. 

26th January, 2024

Many patients, even if they can afford to cover the cost of medication, often face difficulty managing cash flows, especially during long-term treatment plans for chronic conditions. A systematic review of studies shows that when it comes to choosing between expenses, many individuals who suffer from chronic diseases prefer to cut down their expenses on treatments and medicines to save costs. A practical viewpoint shows us that this phenomenon, known as Cost-Related Non-adherence (CRN), is directly related to the rising costs of medication in conjunction with the overall increase in costs of living. Studies also show that many patients with chronic illnesses find it difficult to pay for treatment and medicines because they are already experiencing huge medical expenses for hospitalization, regular checkups, and laboratory testing, among other costs, including expenses related to their standards of living.  

Failing to follow through and complete the treatment course because of financial concerns is a common yet high-risk challenge. While patients may not choose to stop taking medication altogether, many may resort to buying only a portion of the essential or more affordable medications. 

When looking at the long-term implications of this situation, non-adherence to treatment leads to complications for stakeholders involved in the process of providing care and treatment. For patients, non-adherence can include the risk of developing larger, more complicated health issues and comorbidities down the road. For example, when a person with untreated diabetes develops chronic kidney disease, they may end up facing an infinitely more complicated condition. For healthcare providers it further complicates the treatment process, limiting the effectiveness of their course of treatment. Payers who bear the cost of treatment, such as insurers or the government, can face catastrophic outcomes when patient health and medical outcomes are not optimal. For the community at large, it can pose a threat to the outcome of treatment, lower the rate of success, and cause a functioning drug to lose its credibility. Also, specialized care and treatment resources, such as physicians, nurses, and hospitals, are already limited. Not adhering to prescribed treatment procedures reduces the effectiveness of medical care and patient well-being, contributing to the strain on physicians and hospitals, which are already overburdened. 

On-Time Access to Treatment Helps Patients Receive Immediate Financial Support 

Alongside the rapid development of technology and science, there has been a corresponding increase in the number of diseases and individuals suffering from chronic illnesses. If we just take cancer into account, according to data provided by the Centers for Disease Control and Prevention (CDC), in 2017, there were an estimated 18.1 million new cancer cases and 9.6 million cancer deaths worldwide. In 2020, there were an estimated 19.3 million new cancer cases and 10 million cancer deaths worldwide. In 2021, there were an estimated 19.9 million new cancer cases and 10.3 million cancer deaths worldwide, depicting a steady increase in the number of cases. This report from the National Cancer Institute shows that in the future, the number of cases alongside the cancer-attributable costs for medical services and oral prescription drugs are likely to steadily increase. While both these studies confirm that access to newer treatments and medicines and prevention made possible by pre-screening can reduce the number of cancer patients, affordability remains a bigger concern, especially in lower-middle-income countries.  

Recognizing these gaps in treatment, the access experts at Axios International strategically use Axios proprietary scientific tools and real-world insights to design and implement affordable and sustainable access programs. This is why Patient Access Programs (PAPs) managed by Axios International are designed and implemented with sustainability at the core, enabling more patients to receive appropriate treatments, ​complete treatment courses, maximize adherence,​ prevent further complications and serious illnesses,​ and overall minimize the burden on hospitals, physicians, and healthcare providers.

Axios’ Proprietary Scientific Tool – PFET, Assesses The Financial Help A Patient Needs  

The Patient Financial Eligibility Tool (PFET) is a revolutionary development in the field of access to healthcare. PFET, the proprietary tool developed by Axios International, assesses the support and help a patient requires to complete a full course of treatment using evidence-based, real-world data.  

PFET has been successfully used to assess more than 23,000 patients in 30+ countries. In nine cases out of ten, patients agree to be assessed by PFET before enrolling in an Axios-partnered Patient Assistance Program (PAP). The accuracy of PFET’s assessment of a patient’s ability to pay has been verified and commended in the scientific publications Population Health Management and the Journal of Comparative Effectiveness Research.  

One of the success stories of Axios-managed Patient Assistance Programs using PFET comes from Egypt, where the program was launched to provide On-Time Access to Treatment Solutions to patients of Oncology and Hematology. According to the study, a staggering 98% of patients did not have the means to pay for prescribed medication. Even if they had insurance, they did not have funds to pay until the reimbursements arrived. Most patients began receiving treatment and used up their savings and other liquid assets long before they could get reimbursed, leading to treatments being abandoned halfway with inefficient results.  

The study also showed that due to their inability to pay for treatment, many patients neglected treatment after being diagnosed for up to three months prior to the program’s implementation. However, after enrolling in the Axios On-Time Access program, their inability to pay for treatment dropped from three months to just two days. The success of this program is evident in the fact that this number has now been reduced to an average of two days. The Egyptian public healthcare sector has expressed the wish further to support the development of the On-Time Access program to cover more areas of healthcare as well. Asia, Europe, and the Middle East are other regions with similar success rates.  

The program’s ability to ensure that patients receive ongoing care and adhere strictly to their full treatment regimens means that the medical outcomes for patients, after being assessed by PFET, are favorable. 

Once patients’ financial eligibility assessment determining their ability to pay for the treatment is complete, the next step is to enroll the patient in a program that suits their situation the most.  

To mitigate risks concerning patient data, Axios has put in place a strong compliance infrastructure in all its Access to Treatment solutions.​ All processes are aligned with the General Data Protection Regulations (GDPR). At the same time, strict data privacy controls and integrity measures are put in place for the collection, processing, usage, storage, and destruction of personal information.  

Axios-managed PAPs provide equitably affordable access solutions to diagnosis and treatment and help patients overcome their financial barriers, including limited insurance coverage, overwhelming co-pay non-reimbursements, and more. The multistakeholder approach helps Axios design and implement numerous innovative financial methods given to patients as a stand-alone or bridging/ bundled solution, helping patients access treatment. Some of the Access to Treatment Solutions include fixed schemes, tiered cost-sharing, co-pay, on-time access to treatment (short-term financing), direct-to-institution, and many more. 

Fixed Scheme support:  

Under this program, patients are given a fixed offer per the agreement without undergoing a financial eligibility assessment.  

Tiered Cost-Sharing support:  

In this program, the affordability gap that the patient is not able to bear is shared among contributing parties such as charities, NGOs, insurers, governments, pharmaceutical companies, and other potential stakeholders. Sharing the cost decreases the burden on patients and financiers and contributes to increased success rates of treatments and sustainability of the Patient Access Programs. It differs from traditional fixed schemes since patients can pay what they can afford and continue receiving treatment. 

Co-Pay Support:  

Some patients have insurance but with a monthly co-payment amount where the average patient share is 10-30 percent of the monthly medication cost. Following the PFET assessment, Axios facilitates financial support to patients based on their identified needs by offering co-pay support by issuing co-pay vouchers to cover the patient’s share, following the assessment result and quantity of support required.  

Compliance Benefit Scheme:  

This program rewards the patient for their commitment to treatment adherence. For example, if they comply with month X, they will get month Y free of charge. This innovative approach encourages compliance and their journey toward maximized adherence.   

On-Time Access To Treatment (Short-Term Financing) Support: 

This program solution is offered as a value-added service, bundled with other innovative financial treatment programs to help patients overcome cash flow shortages while waiting for support in situations such as delayed insurance reimbursement.   

Based on the individuals’ affordability needs, patients are eligible to receive this value-added service as an immediate treatment or medication support whereby a short-term credit facility is arranged on a zero-interest installment basis to cover the cost for their full course of treatment. Axios facilitates this program solution by working together with multiple stakeholders, such as financial institutions, patients, and pharmaceutical companies.  

With this timely intervention, patients can overcome any unforeseeable delays in beginning or continuing their treatment, resulting in maximized adherence to treatment.  

Since its inception in 1997, Axios International has transformed patients’ lives everywhere with its patient-centric access solutions, which help those who need it most. Carrying on its legacy of supporting patients, Axios has designed and continues to implement innovative access programs in collaboration with broader healthcare stakeholders.  

Today, thousands of patients benefit from this innovative and sustainable access to treatment solutions and programs managed by Axios. This success is apparent and proven by the measurable high success rates and the wholehearted and unbiased acceptance and benefits of the programs, services, and solutions by stakeholders and, most importantly, the patients.