By Casey Speer, Principal & Miranda Brekke, Senior Consultant
In today’s increasingly complex oncology landscape, manufacturers face mounting pressure to launch innovative therapies and optimize adoption for eligible patients across all care settings. An overlooked, yet critical, lever for improving novel product adoption is a deeper understanding of provider hub and satellite site dynamics.
Satellite Opportunity
Many provider organizations today operate under a hub and satellite structure, where a central academic or high-volume community “hub” site is surrounded by smaller “satellite” treatment centers. While hubs often serve as centers of excellence with high patient volumes and complex care capabilities, satellites present unique challenges for patient care as they frequently cater to more localized populations and often manage routine or less complex aspects of care.
Variability in Hub and Satellite Models
It’s important to note variability in hub and satellite models across sites of care. While institutions generally have a centralized hub, community practices function more loosely with one or more “main” site(s) based on patient volume and location. Regardless of model, satellite sites present as a key opportunity for meaningful uptake given increased convenience, geographical reach and untapped patient volume.
When evaluating hub and satellite model variability, the following factors should be considered:
- Provider Specialization: The extent of provider specialization dispersed across sites may vary, as some models have specialists broadly across satellites while others centralize specialists to the hub.
- Decision-Making Power: In some organizations, therapeutic decisions are centralized and made at the hub level; in others, satellites operate more independently.
- Treatment Location: Actual location of treatment may start at the hub and transition to a satellite for ongoing care, or remain local throughout.
For manufacturers, identifying these models and potential impact on portfolio brand adoption is essential for designing appropriate education & support strategies.
The Problem: Limited Novel Product Adoption Across Satellites
Within oncology, novel product adoption at satellite sites remains inconsistent despite increased patient convenience and patient potential. This is due to several systemic challenges:
- Limited Experience: Satellite providers often have less familiarity with novel therapies, impacting data awareness and comfortability with safety and tolerability profiles and leading to decreased adoption of newly approved, innovative therapies.
- Operational Barriers: Distance from hubs, referral relationships, and poor hub coordination / communication create disconnects.
- Awareness and Familiarity Gaps: Satellites may not have the same access to training or updated protocols.
Limited adoption of novel treatment regimens across satellites is most consistently seen across complex oncology regimens which may require additional infrastructure or accreditations to administer therapy (e.g., monitoring, REMS requirement, advanced AE management, etc.), leading to greater satellite reliance on hub sites. Manufacturers must not only ensure these therapies are accessible at hub sites but also equip satellites to handle them confidently.
Solutions: Top-Down and Bottom-Up Support
To bridge the gap between hub and satellite novel product adoption, manufacturers can aim to support organization-wide standardization efforts with direct-to-account and top-down support. For example, direct-to-account support may include clinical pathways refinement & protocol development, while top-down support may target networks, aggregators & societies. Additionally, driving satellite-level interest (e.g., champion activation, best practice sharing, value messaging, etc.) has proven to be critical for complex therapy adoption in oncology.
Strategic Takeaway: Targeted Education & Support by Model
As more patients are seen closer to home & outside of hub locations, manufacturers must move beyond traditional support strategies and target efforts on novel product adoption across high impact satellite sites. Success hinges on understanding how each hub and satellite model operates, considering how and where decisions are made, and tailoring education & support strategies accordingly.