Expanding NPI Visibility & Targeted Engagement in Rare Disease via Lab Data

Executive Summary 

In complex clinical populations like rare disease, lab data serves as a vital leading indicator of patient care. Prior to this initiative, the client had no historical or real-time Quest lab data integration, leaving a critical blind spot in their prescriber landscape. Furthermore, up to 100% of physicians initially associated with raw lab records are often non-treating ordering facilities or reference labs rather than the actual managing provider.

A specialty biopharma brand partnered with Prognos Health and Quest Diagnostics to bridge this gap by combining Quest’s commercial data with Prognos’s proprietary NPI enrichment and attribution algorithms. By deploying a dual-phase solution featuring the Prognos HCP Profiler and Prognos Alerts, the brand expanded its actionable NPI universe for Mycobacterium Avium Complex (MAC) by an average of 220%, pinpointed previously unmapped treating specialists, and dramatically accelerated field engagement timing.

The Challenge: Non-Actionable Data & Diagnostic Lags

Commercial teams managing specialty therapeutics for MAC face persistent friction when identifying treating physicians:

• Zero Baseline Lab Visibility: Without a direct lab data feed, the brand relied solely on lagging secondary sources, missing critical early-stage diagnostic signals.
• The Treating Physician Identification Gap: Diagnostic culture tests are routinely ordered by reference labs, health systems, or non-treating facilities. Relying on unrefined lab data causes field teams to visit the wrong physician's office, wasting marketing resources.
• Lagging Claims Indicators: Traditional claims data captures treatment decisions months after the fact, missing the critical diagnostic window when care plans are actually established.
• Static Target Lists: Legacy prescriber rosters fail to capture newly active pulmonologists and infectious disease specialists currently testing or managing MAC patients in real time.

The Solution: A Two-Phase Quest Lab Data Strategy

To transform raw diagnostic testing into high-fidelity, analytics-ready intelligence, Prognos Health integrated Quest Diagnostics lab data into a two-part execution model - establishing the brand's first-ever pipeline of direct Quest lab data. With Quest serving more than 2 million physicians, approximately 50% of U.S. hospitals, and a patient footprint exceeding 378 million, this provided access to a substantial diagnostic network not previously visible to the brand:

• Phase 1: Prognos HCP Profiler — Integrated and harmonized historic Quest lab results to analyze MAC testing behavior, geographic patient distribution, and baseline physician volume, establishing a high-confidence target universe of active treating NPIs prior to campaign launch.
• Phase 2: Prognos Alerts & Next Best Action — Delivered bi-weekly prospective alerts capturing lab-confirmed MAC patient activity. Utilizing specialized enrichment processes and proprietary rules, this increased treating physician fill rates by 86%+ in rare disease, sending precise, actionable triggers directly to field sales teams and omnichannel marketing platforms.

Business Impact & Value Delivered

• Unrivaled NPI Expansion (Average 220% Increase): Starting from zero Quest data visibility, the solution successfully surfaced a substantial volume of active, qualified treating NPIs managing MAC who were completely missing from the brand's baseline target lists.
• Pre-Decision Engagement: Delivered actionable alerts close to the point of care, allowing commercial teams to engage physicians prior to final treatment decisions.
• Eliminated Wasted Spend: By resolving ordering facility NPIs to the true treating specialist, the brand eliminated wasted promotional spend and improved field targeting efficiency.

Conclusion & Key Takeaways

By combining Quest Diagnostics’ extensive laboratory network, data, and analytics solutions with Prognos Health’s robust data harmonization and NPI enrichment platform, specialty commercial teams can overcome the traditional limitations of lagging claims data. For brands starting without existing lab data coverage, this collaborative approach transforms raw MAC diagnostic test results into actionable, pre-treatment intelligence - delivering an average 220% boost in NPI visibility and ensuring field reps and precision marketing engines connect with the right treating physicians at the precise moment clinical decisions are made.

If you are interested in learning more about how our data-driven solutions can help your commercial team effectively identify and support MAC patients, we invite you to talk with us further - reach out to us here.