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Pharma abandonment and reversal rates? How are they different?

Written by Al Kenney on 18 April 2016. Posted in Co-Pay Program Optimization

abandonment

We always find that there is confusion among brand team members when we talk about abandonment rates. Many people confuse abandonment rates with reversal rates and think they are one in the same… they are not!

Let me take you through the explanation of how each is calculated.

 

 

 

scriptswrittenfilled

We start with the written scripts show in Figure 1. Then, in Figure 2, we look at the pharma industry average of scripts which are filled vs. those that are not filled. Based on past studies that have been performed across all of pharma, we know that (on average) scripts are filled 65% of the time, which leaves 35% of scripts unfilled.   As in Figure 3, a portion of the filled scripts utilize a copay card. This number is different for each brand depending on their offer and strategy.

Now, let’s examine Figure 4, the 40% of the equation which represents non-filled scripts. In many of these cases we just don’t know why the patient didn’t fill. There is no information here because the script was never presented to the pharmacy so there is no record and no reason. It could be that they never intended to fill the script. The rest of the time, we see an entry by the pharmacist into the NCPDP system and a reversal occurs for a variety of reasons:

There are many reasons for a reversal:

  • Rejected claims
  • Entry mishaps
  • E-prescribing script that was never filled (auto send script to pharmacy with no intent to fill)
  • Invalid claim
  • And about 30% of the reversals are actually the abandoned prescriptions (due to price). So that would be 30% of the 40% slice of the “unfilled” pie = 13.0% overall

scriptsall

So here you can see that abandonment rates are actually a subset of the reversal rates. If you are tracking reversal rates thinking they are a measure of abandonment, you are incorrect. You need to be able to break down the reversal rate into the abandonment rate (usually about 10% of unfilled scripts and less than half of all “reversed scripts”) to get a more accurate read on the patients who actually presented to the pharmacy and abandoned their script there (probably due to a price issue).