What results should you be expecting from your patient copay program?

Written by Al Kenney on 18 December 2017. Posted in Co-Pay Program Optimization


We are asked all the time about benchmarking of copay programs. “What are other brands getting?” “What is a reasonable expectation?” Many times the questions are focused on a specific KPI such as redemption rates, abandonment rates, reversal rates or utilization rates. While a brand team might find it helpful to track these KPI over time, we believe the best benchmarking measure is incremental volume or incremental days of therapy.

Redemption rates are not something that you should be tracking against other brands either inside or outside of your organization as they are very dependent on the vehicles you use, the number of offers in market etc. In addition, having a higher redemption rate isn’t always the best thing. For example, if redemptions go up but incremental volume stays the same that isn’t good!

The same thing goes for abandonment and reversal rates. There are many things that impact these rates which I address in my past blog specifically on abandonment and reversal rates. These two measures are often confused and they are not the same. Reversals include abandonments (due to price) but they also include mistakes made by pharmacists among other things. Given the confusion around these rates and the many factors that can impact these rates, we do not suggest using these rates for benchmarking purposes.

Utilization rates are also problematic for benchmarking. You can certainly track them, but most times having a goal of higher utilization rates isn’t a solid one. Again it’s incremental volume you should strive for (see our white paper on this subject on our website). And higher incremental volume comes from giving a better benefit to patients with higher OOP costs who probably can’t afford their medications. Think about that next time you are contemplating an OOP price less than $20 - Could that money be redirected to patients with higher OOP costs to drive more incremental volume?

So what are some of the meaningful things you can track and benchmark against? The main measure should be incremental volume or incremental days of therapy. For a chronic brand you should be shooting for an extra 30 days of therapy. And for many acute brands, probably half that would be a good target (15 days incremental). For unique brand situations…contact me and we will have an in-depth discussion!