The Blue Tree, India
An oncology patient support initiative, designed to take care of the multiple hurdles that a patient has to go through during the course of accessing treatment. The program, through a single platform, mimics the patient journey and enables patients to overcome access hurdles, including diagnosis, reimbursement, affordability and adherence.
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To provide a comprehensive and integrated patient support program to overcome the multiple hurdles that a patient has to go through to receive treatment for cancer. The programme strives to ensure that all aspects of treatment are covered: from disease awareness and testing, funding solutions, home delivery of drugs, adherence support and standardised reports.
What are the health needs and challenges?
In India, more than 1.3 million people develop cancer each year. Cancer is the third highest cause of death amongst non-communicable diseases (NCDs).
Although affordability is often cited as the cause of this poor cancer care access, there are many other barriers to treatment. These include late diagnosis, limited and hard to-reach infrastructure, low awareness of treatment options, inadequate biomarker testing, lack of reimbursement of medicines, and poor adherence to treatment. Only one out of four patients who are prescribed medicines actually starts the treatment and only a few of these barriers are being addressed. India does not have universal access to healthcare or centralized payers, however it does have large central and regional healthcare funding programs. These programs typically offer coverage to government employees and their families. A few programs are also designed for the economically disadvantaged segment of the population. In addition, various NGOs (non-governmental organisations) and pharmaceutical companies provide patient assistance programmes.
Hence, it can be confusing for a patient to be able to navigate these multiple challenges and platforms for initiating cancer therapy.
Partnership activities and how they address needs and challenges
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 accessing treatment. The program, through a single platform, mimics the patient journey and enables patients to overcome access hurdles, including diagnosis, reimbursement, affordability and adherence. It does so by providing services such as bio-marker test support, guidance on sources of funding, reimbursement documentation assistance, disease information, drug access support, drug delivery at home and infusion reminder calls.
The programme services can be grouped in four broad categories:
- Disease awareness and Testing: Disease awareness material is provided to patients via the doctors in 9 languages across 5 different types of cancers (Breast, Lung, Colorectal, Ovarian and Cervical Cancer). Biomarker testing support is also provided for patients who cannot afford, or do not have access to quality testing facilities.
- Funding solutions: Affordability of treatment is a significant issue in India, with many patients having to pay for treatment out of pocket. To help these patients, program coordinators discuss with them alternative sources of funding including bundled health insurance, state and central government available schemes, preferential loan features of savings bank accounts, life insurance and cooperative society memberships. In case a patient is not able to obtain the treatment via these schemes the patient is assisted by providing information about various funds made available through hospital trusts and charitable organizations. This information helps ensure that affordability is not a barrier to treatment. 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: This is an important factor in ensuring patients are fully and properly treated. With many on day wages, coming to a hospital for treatment can mean a loss of income. To address this, our programme coordinators reach out to the patient at set frequencies, especially before and after infusion cycles. Patients are additionally supported with our patient access programmes which are available for all key products (Avastin (Bevacizumab), Herclon (Trastuzumab), Perjeta (Pertuzumab), Kadcyla (Trastuzumab Emtansine), Gazyva (Obinutuzumab), Ristova, Xeloda, Tarceva (Erlotinib), Alcensa (Alectinib)). In remote locations where there are medicine availability challenges, we arrange delivery to the patient’s home
- Customized Reports: The programme also updates prescribers with summary records and service profiles of enrolled patients to ensure proper monitoring of treatment.
Patient centricity is at the core of The Blue Tree Programme and our partnerships reflect this. We work only with like-minded organisations to ensure that our solutions and access initiatives are both sustainable and consistent. The Blue Tree has partnered with multiple partners such as a call centre, distributor, bank, logistics provider, diagnostic center and many others to make this programme a reality.
"Even on a heavy rainy day The Blue Tree field coordinator fully drenched took all the pain to come home and collect the relevant papers for the last dose. The team from Mumbai had also coordinated the supply so efficiently and in time."
Results and milestones
The Blue Tree programme has touched patients’ lives by adopting a systematic and comprehensive approach.
Since program inception, more than 750 doctors have supported the programme, resulting in the enrollment of more than 5,000 patients till end of 2017. 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 2017. More than 1800 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 month on month since programme initiation. The programme success is a result of partnership with call center, distributors, financial institutions, logistics providers, and several others who share our patient-centric approach.
The Blue Tree Programme was also presented as a best practice example in patient access solution at a side event in 72nd United Nations General Assembly in 2017.
- South-East Asia
- Non-communicable Diseases
SGDs the partnership contributes to
- 3.4: NCDs (including mental health)
- 3.8: Achieve universal health coverage
Logistics and Supply Chain
Other Business Sector
- Breast Cancer
- Cervical Cancer
- Colorectal Cancer
- Hematological Cancers
- Lung Cancer
- Non-Small Cell Lung Cancer (NSCLC)
- Brain Cancer
- Ovarian Cancer
- Renal Cell Cancer