Blending Business Strategies and Clinical Expertise Can Help Manage Rising Drug Spend

The role of the Clinical Account Executive (CAE) at Elixir is a very important one for helping clients identify pharmacy trends and implement appropriate clinical programs for their membership. It’s a role that utilizes the clinical expertise of a pharmacist with a business outlook to devise cost-saving strategies, which appealed to Hiral Patel, senior clinical account executive at Elixir. As a two-year-veteran senior clinical account executive who manages four other CAEs, Hiral and his team serve as an extension of our clients’ account management teams, analyzing physician prescribing and client utilization patterns to develop formulary management strategies and cost-effective clinical solutions for clients.

“We strive to support our client and consultant partners in identifying pharmacy trends and educating them on clinical programs and solutions,” Hiral explained. “We serve as an integral part of the account team for every client, ranging from a small, 50-employee company to a large, national employer. Our team of pharmacists and analysts have a unique skillset in that we have a clinical background in a client-facing role.”

As a licensed pharmacist with an MBA, it was important to Hiral to have a career that combines the clinical and business side. Hiral started his career as a pharmacist in a retail setting while obtaining his MBA from the University of Findlay in Ohio. “My family background is in the hospitality and lodging industry, so the business side is in my blood.” Hiral said. “I wanted a career that blended pharmacy and business acumen.” He first got this blended experience while working with a Blue Cross group in Michigan. “I experienced the challenge of working with clients, looking at data from a business perspective and helping clients reduce spend,” Hiral stated. “At the time, the specialty drug market started to take off and I knew there was an opportunity to help manage that area.”

Before joining Elixir, Hiral also worked for a pharmacy consultant with a variety of PBMs, getting to know the industry. He joined Elixir after deciding he could make a strong impact working directly with clients to help them manage spend. “Elixir has the right mix of operations and offerings where I felt I could make a difference. I like their willingness to be flexible and work with clients. We focus on what the client wants to accomplish, look at what the client wants and understand what they need.”

It is this flexibility and understanding that Hiral feels is needed to manage what he sees as the most pressing trend in pharmacy benefit management, the continued rise in specialty drug costs.

“Specialty drugs account for more than half of pharmacy drug spend for many clients,” Hiral explained. “Our approach to managing these high-cost, high-touch therapies needs to be multifaceted. Not only do we need to control costs, we also need to eliminate wasteful spending and make sure members are staying adherent to their treatment.”

Hiral and his team work to develop crafted clinical solutions to help clients manage these complex medications. “At Elixir, we’re flexible enough to provide benefit design strategies that can be customizable to meet our clients’ needs,” Hiral stated. “One way that we’ve accomplished this is by bringing forth benefit-design-based strategies to reduce plan spend, both from a specialty drug perspective and non-specialty drug perspective. Our copay management solutions provide savings for payers while keeping the member experience intact throughout the entire process.”

With our copay management solutions, we track copay assistance from manufacturers that is applied to specialty prescriptions and, depending on the plan design options, help maximize the copays tracked. Members receive the benefit of assistance to afford branded specialty medications and we ensure that our clients do not begin bearing the majority of the medication cost before the deductible is actually achieved.

Hiral explained how our specialty pharmacy, Elixir Specialty, also makes a difference in managing specialty drug spend. “While many specialty pharmacies have become more focused on dispensing, our specialty pharmacy has remained high touch and personalized,” Hiral said. “Our specialty pharmacists stay in close communication to monitor and support members when needed, while developing personalized care plans based on the member’s condition and prescribed treatment. This approach increases adherence and maximizes the effectiveness of their therapy. Elixir Specialty Pharmacy has consistently performed better than benchmark in adherence measures and 90-day discontinuation rates. This ultimately leads to long-term treatment success and better therapeutic outcomes.”

As Hiral and his team provide our clients with day-to-day clinical support, he explained, “We have a great team environment. We all share common goals and most of them revolve around our clients.”

Hiral-Patel-Family-CroppedHiral is just one example of the professionals at Elixir who do more than just their job and really work to assist our clients in managing their drug spend while still helping members achieve whole health for life. Throughout the year, we will profile other Elixir leaders and how they’re making a difference.

Name: Hiral Patel
Title: Senior Clinical Account Executive
Tenure with Elixir: 2 years
Education: PharmD from the University of Michigan, MBA from the University of Findlay
Family: Married for 14 years with two daughters, ages 5 and 7

Topics: Getting to know Elixir