Automating Dupixent Peer-to-Peer Scheduling for Specialty Therapies

The Dupixent PA Challenge & P2P Necessity

Dupixent, an IL-4/IL-13 inhibitor, is indicated for conditions such as atopic dermatitis, asthma, eosinophilic esophagitis, and chronic rhinosinusitis with nasal polyps. Prior authorization denials for Dupixent frequently stem from unmet step-therapy requirements, insufficient documentation of prior therapy failures, or questions regarding medical necessity for specific indications. These denials often necessitate a peer-to-peer review to provide additional clinical context and advocate for patient access, making efficient P2P scheduling critical.

Manual P2P Scheduling Bottlenecks for Dupixent

• **Clinician Calendar Availability:** Reconciling payer medical director availability with the ordering clinician's packed schedule, especially for high-volume Dupixent prescribers, often leads to delays.
• **Time-Sensitive Windows:** Payer-offered P2P windows can be short, increasing the risk of missing opportunities and forcing cases into a lengthier formal appeals process.
• **Pre-Call Documentation Gaps:** Manually gathering comprehensive clinical notes, lab results (e.g., eosinophil counts), and prior therapy history for Dupixent's diverse indications is time-consuming and prone to omissions.
• **High Clinician Burden:** The manual effort of scheduling and preparing for P2P calls for specialty drugs like Dupixent contributes significantly to clinician burnout, as noted in AMA surveys.

Klivira's Automated Dupixent Peer-to-Peer Scheduling Workflow

Klivira's platform automates the entire peer-to-peer scheduling process, starting with auto-detection of P2P-eligible denials for Dupixent. Our system ingests payer-side availability windows and integrates with clinician calendars via FHIR Appointment resource or customer-configured systems (Outlook, Google Calendar) to propose optimal, mutually available call times. This significantly reduces the administrative burden on PA coordinators and clinicians, accelerating the path to approval for critical Dupixent therapies.

Key Documentation for Dupixent P2P Reviews

• **Prior Therapy Failures:** Detailed history of failed conventional treatments (e.g., topical corticosteroids for atopic dermatitis, inhaled corticosteroids for asthma).
• **Severity Assessments:** Objective measures like EASI scores for atopic dermatitis, FEV1 for asthma, or symptom scores for chronic rhinosinusitis with nasal polyps.
• **Diagnostic Confirmation:** Biopsy results confirming eosinophilic esophagitis, or imaging (CT scans) for chronic rhinosinusitis with nasal polyps.
• **Lab Results:** Relevant blood work, such as eosinophil counts, to support diagnostic criteria or treatment rationale.
• **Clinical Notes:** Comprehensive progress notes detailing patient response to previous therapies, contraindications, and rationale for Dupixent initiation.

Seamless Integration for Dupixent PA Management

Klivira ensures end-to-end data flow for Dupixent P2P cases. Automated documentation discovery via FHIR pulls necessary clinical notes, prior-line therapy, and lab/imaging results directly from the EMR to assemble a structured clinical-talking-points packet for the clinician. Post-call, outcomes are captured via a structured form, written back to the EMR as FHIR DocumentReference and Communication resources, and trigger downstream workflows, providing a comprehensive audit trail and reducing manual data entry.

Driving Efficiency and Reducing Clinician Burden

By automating Dupixent peer-to-peer scheduling, Klivira directly addresses key pain points identified in industry benchmarks like the AMA prior authorization physician survey. Our solution minimizes the clinician hours spent on PA-related administrative tasks, allowing them to focus on patient care. Furthermore, Klivira's P2P pattern analytics provide insights into denial reasons and success rates, enabling continuous improvement in upstream PA submissions for high-volume specialty drugs.