The Patient Journey: Improving Access to CVD Care

Jen Norton, vice president and head of US Value & Access, Amgen, shares how stakeholders across the health care system can collaborate to address the unmet needs of patients with cardiovascular disease.

This interview is part of the series, "Innovation in Cardiovascular Disease Care & Coverage."

Read the full transcript:

My name is Jen Norton. I'm the vice president and head of US Value & Access at Amgen.

Can you walk us through the patient journey within the health care system and highlight critical decision points for patients, prescribers, and payers?

Absolutely. There are many challenges and barriers across the care continuum from the atherosclerotic cardiovascular disease (ASCVD) event happening to the patient discharge, treatment, and ongoing follow-up care. One way we can evolve our health care system to better support these patients is to ensure care pathways and system-level decisions support appropriate use of medicines.

Often, lipid management is not top-of-mind for clinicians during index hospitalization because of the demanding environment and the urgency to treat acute issues. At the first point of the care continuum, after an acute cardiovascular (CV) event, the very high-risk patients are not being flagged for escalated engagement at discharge. Patients are also rapidly discharged, and clinicians frequently miss the opportunity to educate hospitalized patients on cholesterol, on low density lipoprotein cholesterol (LDLC) goals and comprehensive CV risk reduction.

After discharge, LDLC often is not monitored regularly. Patients do not get follow-up LDLC tests after ASCVD events, despite physician orders. Patients may also encounter access issues from prescribers, as well as payers.

Primary care physicians (PCPs) and cardiologists both treat patients, but most patients interface with a PCP, who is more likely to be concerned about rejection rates, the burden of preauthorization requirements for prescription drugs, and reserving nonstatin lipid-lowering therapies for higher risk patients with ASCVD.

Recurrent ASCVD events are frequent and may occur before a patient has had a follow-up visit. Patients that experience recurrent ASCVD events often have gaps in LDLC management.

How should stakeholders within the health care system work to improve the management of CVD?

There are missed opportunities for lipid management discussion and patient-directed education at various points in the care continuum: at the inpatient point, in transitions of care, as well as in follow-up care. Well written discharge plans and coordinated follow-up appointments will help to improve care postdischarge. Patient education and digital health tools can also deliver education and support treatment adherence to improve overall lipid management.

Amgen is seeking to intervene earlier to help improve patient outcomes, reduce costs, address population health, and deliver sustainable long-term value to patients, as well as to the entire health care ecosystem.

What are some ways to address unmet needs of patients presenting with CVD?

Real-world data plays an important role in supporting health care systems to determine which medications and treatments provide the greatest value. Real-world data helps show the critical inflection points in the patient journey by allowing us to see if and how patients are receiving treatment that is most appropriate.

Amgen is using real-world data to identify gaps in care, as well as system-level processes that can be implemented with our partners to support appropriate LDLC management, including the appropriate use of lipid-lowering therapies according to guidelines. It is important that we work with partners across the ecosystem and address these opportunities holistically to ensure we're doing the most to maximize patient outcomes as well as population health.