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The Roadmap

Written by Al Kenney on 27 June 2016. Posted in Co-Pay Program Optimization

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The Roadmap to Capturing Incremental Scripts through Effective Patient Copay Programs

Adjudicated patient copay programs have been around since 2005. What appears to be a simple program to devise and implement on the surface, has continued to be anything but that.

At last count, annual spending on Pharma copay programs was estimated at over $6 billion dollars. Yet, with all of that spending there are still very few brands that have gotten it right. Getting it "wrong" costs the brands hundreds of millions in wasted spend. I am defining "wasted spend" as money that was used to subsidize the OOP costs for a patient who would have purchased anyway based on their acceptable OOP cost (may include a manufacturer discount). Buying the price down below this price inflection point is the major driver here. Brands should be looking at optimizing their copay programs as an untapped opportunity or low hanging fruit. This is done by getting the offer right and reducing OOP costs for the patients who have high abandonment due to high OOP costs. This does not mean bringing down an already acceptable cost to something even lower.

You need to think of your managed care contracting efforts as the pillars on which your overall promotional strategy can be built. The first thing you must do is understand the position you are in when it comes to patient out of pocket costs. Many brands start with an average patient OOP estimate, but often times, those estimates are incorrect and do not consider the impact of high deductible health care plans or the impact of the patients who are insured but not covered. Many brands make the mistake of basing their copay program offer off their average patient OOP cost and this leads to a suboptimal program design. For more on this topic and the importance of generating incremental volume, download my latest whitepaper entitled "The Roadmap to Capturing Incremental Scripts through Effective Patient Copay Programs".

Alpha1C Roadmap to Capturing Copay Volumne White PaperFor more on this topic and the importance of generating incremental volume, click the image to download my latest whitepaper entitled, The Roadmap to Capturing Copay Program Incremental Volume: How to Capture Incremental Scripts through Effective Copay Programs.