app.premier-c2c.io / veltessa / archetypes / pa-step-therapy

Archetype: PA step-therapy gap

INSIGHT PLANE · DE-IDENTIFIED
412 patient-equivalents match this archetype  ·  academic oncology centers  ·  commercial plans with a step-therapy edit  ·  recoverable
The Pattern the Model Found · derived across the cohort, not one record
Dx → e-RxDay 0–1

Therapy ordered and routed to specialty pharmacy.

PA submitted~Day 3

Plan requires step-therapy documentation.

PA denied~Day 11

Step-therapy history not attached — a documentation gap.

StallDay 14+

No fill; no outreach is triggered on the current path.

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DIAGNOSIS: Recoverable at scale. For this cohort the denial is a documentation gap, not a coverage rejection. A peer-to-peer with step-therapy history clears it — the brand can fund a play for the whole archetype.

The 'Why', At Cohort Level

A recoverable pattern — not a patient file.

  • The model reasons across de-identified substrate data to characterize the archetype and its break point.
  • It separates a recoverable documentation gap from a true denial — they need different plays.
  • The brand decides policy for a cohort; it never opens an individual's record to do so.
Care-to-Commercial Intelligence OSConcept Demo · Therapy Access OS
000102Archetype03040506