Co-Pay Program Optimization

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Brand lifecycle - a key driver

Written by Al Kenney on Monday, 30 May 2016 00:00. Posted in Co-Pay Program Optimization

lifecycle

Brand lifecycle:  The often forgotten, but major consideration when structuring your patient copay program.

There are many factors influencing your copay program but a key driver impacting your program objectives is where the brand is in its lifecycle. Your objectives for the brand will certainly be different depending on which lifecycle stage your brand is in:

Launch – At launch, you want to drive as much trial as possible so this is when most brands put forth their most lucrative offer. The key here is to give enough of an incentive to get the fill but not to give more than is necessary. If your brand has a unique point of difference you may not have to go as deep as some of your competitors.  

Growth stage – When the brand is firmly in the growth stage, copay offers still need to provide a good incentive, but you can start to dial the offer back a bit once you feel your brand has good traction and acceptance with your HCP’s.  

Maturity – Once your brand is mature and/or a leader in the category, you might want to dial your offer back even more to try and capture a bit more profitability before going into the decline stage (pre-LOE). You will also be more focused on driving increased adherence and ROI more than ever before.

Decline – There will be a decline stage as the brand approaches its loss of exclusivity date. Here your strategy will be to maintain or increase patient adherence rates prior to the loss of exclusivity.

During each of these brand stages having the right offer in place is the best way for you to achieve your brand goals. Optimizing the offer amounts, caps, # uses etc. for the brand’s life stage is critical to achieving the brand’s goals. Alpha 1C’s modeling tools let you set and change your brand’s goals on the fly and will recommend the offer that best meets those goals in a simple easy manner. This way you are sure that the offer you have in market at all stages of your brand’s lifecycle actually delvers what you are looking for.    

 

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Is this really your patient adherence curve?

Written by Al Kenney on Monday, 09 May 2016 00:00. Posted in Co-Pay Program Optimization

patientsbyusage

We have many clients who misinterpret reports and data from their copay program vendors. One of the most misinterpreted reports we see is this one showing copay card usage which is sent to clients by their copay vendors each month.

When asked about their adherence curve, many times clients send us this graph. They may also complain that their adherence curve doesn’t look as good as it should and they conclude that there must be something wrong with their copay program. We explain to them that the copay card usage information shown in this graph is not their adherence curve…at least not yet.

This report tracks how many times patients have been utilizing their copay offer on a program to date basis. It is important to remember that patients are entering the program each month while the program is still in effect. Each new patient using the copay card will be recorded in “Use 1” regardless of when they entered during the program’s effective dates. That patient will be recorded in the “Use 2” grouping if and when they use the card a second time. The counts of claims are actually laid on top of each other regardless of when the use actually occurred and that causes the confusion. For example: you have thirty three new patients come into the program this month counted as script #1, another twenty two who have filled twice (started last month) and then groups of patients that have filled three, four, five and six times.

Put them all together in one report and what do you get? You get a bunch of mush that is hard to interpret! A high first use number and low second use number may indicate that new patients have dropped therapy. Or, alternatively, those new patients may not yet have reached the point of needing a second or third fill (they may still be on their first script). Looking at this graph as a representation of the average patient’s adherence over time will cause you much anxiety!

Once the program is closed down and all of the patients have cycled through (6 months after the program is over), then the final version of this chart will give you a much better indication of what your adherence rates really look like. Until then, this report has very little value as a proxy for a brand’s adherence curve.  

 

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Pharma abandonment and reversal rates? How are they different?

Written by Al Kenney on Monday, 18 April 2016 00:00. 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).

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Is your patient copay program subsidy reaching the correct patients?

Written by Al Kenney on Monday, 28 March 2016 00:00. Posted in Co-Pay Program Optimization

costsummary

You may have heard me talk a lot about how to properly utilize your copay program to deliver the results you need. The most effective way to do this is to utilize your copay program as a safety net in conjunction with your existing managed care coverage.

Your copay offer should work together with, not against, your managed care strategy. When your copay program overlaps, or conflicts with your managed care strategy, you’ll find a lot of wasted spend. This is not an effective approach as it won’t deliver the results you need and certainly won’t deliver the “holy grail” of copay programs: generating incremental volume and adherence increases for your brand.

We give our clients several unique “looks” at their spending through our advanced analysis and reporting tools so they can easily spot issues and opportunities. One of most effective views is a chart showing the patient copay amounts (pre and post copay card) as well as the program spending by copay group. Looking at the chart you can see the average patient OOP based on managed care contracts in the blue line and the average patient OOP after the copay card in the tan line. The bar graph shows the amount of spending for the brand against each of the patient copay groups. The example we show here indicates that $9.1MM was spent on the patients with $150+ copay OOP.

The trend you see in this example is exactly what you want and hope to see…bar graphs are getting larger from left to right which means there is a higher percentage of total program spend going towards the patients who actually need it most (those with high copays). Depending on how the spending is spread, this can deliver high incremental volume results. You would think that the chart would always look this way…but think again! Many types of program offers actually focus spending on patients with lower copays (those patients who would have filled anyway). With a graph like this, you can easily see if you are putting your budget where it will get you the best result for your brand. Putting your spending against patients with higher copays will ensure higher incremental volume and higher ROI for your spend.  

 

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How much category data do you need?

Written by Al Kenney on Monday, 07 March 2016 00:00. Posted in Co-Pay Program Optimization

analytics

One question I hear from time to time from brand teams/managers is a question about copay data. Specifically how much category or sub-category copay data is needed in order to perform an optimization of their brand’s copay offer? While we know that every brand and category is completely unique in many areas, we’ve found that copay redemption data is not the main ingredient necessary to perform a detailed copay program offer optimization.

There are many pieces of data necessary when performing this highly detailed analysis. The brands adherence and abandonment rates over time play a key role as does the competitive arena in which the brand competes. But the fact is that the overwhelming drivers for this type of analysis are:

  1. How the drug performs and where the drug fits in importance from the patients that take it – will the patient feels the positive effects of the drug in month #1? Is this an add-on therapy? Are there four or five other drugs which the patient might also be taking? Knowing what is happening with your patients and when the greatest potential for abandonment would happen is vitally important in the process. Where would your drug rank in terms of importance to the average patient who needs it?  
  2. How much are these patients already spending on other therapies? – Knowing if your average patient is already spending $150 per month on other more pressing therapies will have a major impact on your brand’s strategy to make your drug affordable for your patient on top of everything else they have going on.
  3. WAC price, margin and the relationship of the price discount – we can learn a lot from the data from drugs in other categories with similar profiles who might have nothing else in common besides a similar WAC price and similar discounting strategy. If the drugs are seen as having the same level of importance to their patient base then watching what happens with their price discounting strategy will yield some vital key
  4. Knowing your current Managed Care position – knowing what you think is your average patient copay is can lead you down the wrong path. We have seen that time after time brand managers misinterpret the information they are seeing in their copay pharmacy data and make bad decisions with it. Most of the time the average copay numbers you see in this data is the average copay for patients that took advantage of your offer. Different offer structures can get you vastly different patients utilizing them. The numbers you want to look at and use are the ones provided from your managed care team keeping in mind the impact of the high deductible

I no way to I mean to say that these are the only factors to consider however they are some of the most important and most overlooked when it comes to optimizing your patient copay offer structure.  

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Co-Pay Program Spend Optimization Possible for Pharma Brands?

Written by Al Kenney on Monday, 15 February 2016 00:00. Posted in Co-Pay Program Optimization

virtual reality

The most progressive Pharma companies (many of which have the most to gain from optimizing their tremendous spending on co-pay programs) have just begun to embrace the idea of optimizing their spending on co-pay programs.

The upside is obvious and can be documented: cost savings, increased efficiency, effectiveness, and increased ROI. The financial benefits are likely in the hundreds of millions of dollars if not the billion dollar range across major brands. However, even with the amount of money on the table, the majority of Pharma companies don’t recognize the magnitude of the opportunity in front of them.

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Is there a Halo Effect Present in My Co-Pay Program?

Written by Al Kenney on Monday, 25 January 2016 00:00. Posted in Co-Pay Program Optimization

halo

For years, many have asked whether there is a positive “halo” effect related to copay programs…and if so, where are the key areas of impact? Many have pointed to a variety of potential positive impact areas including:  

 

      • Impact on HCP’s writing

 

  • Impact on patient adherence

  • Impact of patient support reinforcement even if the patient is unable to utilize the discount

Although many believe in a “halo” effect, there has never been a major study done to quantify the true halo impact above and beyond what can be seen in claims data. We have seen presentations from some copay vendors indicating they believe that the impact can be an additional 100% of sales or more – I’d say that’s a reach, but I do believe there is a level of halo present with copay cards for the following:

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HCP's Role in your Co-Pay Program

Written by Al Kenney on Monday, 04 January 2016 00:00. Posted in Co-Pay Program Optimization

pharmacist patient interaction

For years, the most popular way to distribute your co-pay offers has been via sales reps to your targeted physicians. It’s a fact that the combination of receiving both a script and a co-pay offset card is a powerful motivator encouraging patients to actually get the script filled. These copay cards demonstrate that the brand is being supported and also give the rep the ability to alleviate physician’s concerns about their patients being able to afford the optimal therapy.

 

We saw from Sheri Sellmeyer’s blog post, the Decision Resources survey of 144 physicians (74 psychiatrists and 70 HCP’s) indicated that ninety percent of PCPs and 80% of psychiatrists encourage the use of coupons, highlighting the importance that these programs now play for mental health therapies as well as for other therapies. The physicians estimated that close to a third of their patients benefited from reduced copays and in some therapeutic classes, that number can be much higher.

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A Geo-Targeted Approach

Written by Al Kenney on Monday, 14 December 2015 00:00. Posted in Co-Pay Program Optimization

DMA

The industry has begun to embrace a geo-targeted market level approach to delivering co-pay incentives. It’s taken a long time to get there and there is still much more to be done in making these programs easier to deploy and getting pharma companies to address the two perceived issues with their implementation: legality and fairness.

Is it legal?  Is it legal to deploy different offers in different markets? We’ve checked with our government legal contacts and have been told that there is nothing in the law that prevents any pharma company from delivering a market level offer (below the state level). However, every company will have its own interpretation of the law. The good news is that most agree it’s legal on the regional and state level. But, we know of at least one company that believes that taking it below the state level isn’t legal because they feel “every patient in each state must have the ability to receive the same offer”. On the other side of the spectrum we have an un-named company which has been taking the most conservative approach where their legal department will tell you that they believe co-pay assistance of any kind is illegal (but they still allow co-pay programs on their co-promoted brands).

Understanding how your company interprets the law with respect to copay program structure is critical as you are developing your program.   We have found varying opinions not only on varying offers based on geography, but also on questions such as the following:

  • Can I have a more (or less) aggressive offer for my brand available on-line?
  • Can I have a different offer for cash payers vs. an insured patient?
  • Can I have a more lucrative offer for those patients who sign up for my relationship marketing program?

We routinely see copay programs with varying offers for different patient groups or delivery channels (web vs. in office for example). Given the variations we’ve already seen, it naturally follows that offers could also be varied based on the specific needs of a particular geography. However, we encourage you to check with your legal department as you are developing your program to ensure that you are operating in-line with their interpretation of the law!

Is it fair for the sales reps?  Another initial resistance we sometimes hear is that the marketing folks believe that having different offers by market may not be fair for the sales force. On the surface it seems like a reasonable roadblock until you really dig in and look at what is currently happening.

I used to be a sales rep and had lower Manhattan as my first territory. It was a great and highly affluent territory and I always did well. Just a few blocks above me the Manhattan north territory went from 96th street north and included all of Harlem which at the time was certainly not as affluent as the consumers in my area. A sale of Advil 165 count at the time was $13.99 for both areas and I knew I had more people in my territory that had the extra cash to purchase the larger size.  

When each of our reps got the same marketing plan to implement, the Manhattan South territory would have a decided advantage. That was readily accepted by the company and the way it was overcome was that the rep in the north Manhattan territory would have to show reasonable success and then they would be moved up to a more lucrative territory as part of their career advancement strategy.

The same inconsistencies are still prevalent in the sales territories today and certainly pharma products with their higher prices can cause even more of a gap. Addressing each area/territory individually and tailoring an offer that reflects their market conditions for managed care coverage and affordability actually levels the playing field. This is also advantageous for the patients as well as the physicians practicing in these areas as it alleviates the self-imposed pressure they are under to help provide affordable healthcare for their patients.

So, based on our experience we believe that varying offers based on geographic needs is not only legal and fair, but is the best approach. But, as I noted above, check with your legal department before finalizing your program details!

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Optimizing Your Business Rules

Written by Al Kenney on Monday, 30 November 2015 00:00. Posted in Co-Pay Program Optimization

paying at register

With the emergence of the new Obamacare exchanges and as the deductibles for many insurance plans are rising, you need to pay more attention to your business rules in your co-pay program now more than ever.

This is an essential step to ensure all your strategic thinking gets executed at the in the pharmacy exactly as you had specked it out. There are many examples where loosely built business rules cost brands millions more simply because the implementation objectives were not understood thoroughly and subsequently not set up properly. One of the biggest rule oversights is how your program treats the ever growing group “insured but not covered patients” (INC). These may be patients may just starting the year and paying towards their deductibles, or may be new to your drug, and/or their plan may not have your drug on their formulary plan yet.

Depending on your brand’s specific situation you may want to set up your business rules to specifically address these INC patients to accommodate all of your potential patient population. You should not only understand the possible number of INC patients you may have presenting your offer at the pharmacy but the potential impact of the two different types of INC patients and think about the way those patients will be treated in the delivery and execution of your offer.

There are technically at least two types of INC patients who are clearly in different situations:

  1. Those who have insurance but don’t have formulary coverage for your brand (so these are really cash payers who are “insured”),
  2. The INC patient who has commercial insurance coverage for your brand but needs to satisfy an OOP deductible. These patients will eventually be covered for your brand just not right now

INC-“A” patients will be thrown over into your cash payer bucket. This is why you need to pay special attention to your cash offer (or should think about having one). If you have no cash payer offer there will be a high likelihood they will not fill due to having to pay your retail price point and you can wave bye-bye to them.

If you feel the majority of your INC patients are in type “B” and will be starting the calendar year paying out of pocket towards their deductibles and your offer is equal or more lucrative for your cash paying patients you should think about setting your business rules to specifically state that insured patients cannot be processed as cash payers, as if this is allowed it could cost you a bundle.

On the other hand if you know a high number of potential patients not have your drug on their formulary plan yet you may want to allow these patients to be treated as cash payers (in the NCPDP system) they will not be considered cash payers even though they have to pay cash because they technically have insurance coverage (just not for your brand).

Another problem is you don’t know the percentage breakdown of these two INC patient groups and this makes it hard to plan out your strategy. You should make an educated guess to get the process started. These programs have many business rule configurations and stumbling on any of them will cost you big!

If you slack even a little bit on the rules you may leave the door open for the pharmacist to process commercially insured INC patients as cash patients (as one example) and this could have a devastating impact on your strategy and your bottom line. Just remember to spend the extra time to correctly understand and configure your programs business rules. It’s something that is easy to do but sometimes forgotten.    

 

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Understanding the Impact of Your Patient Adherence Curve

Written by Al Kenney on Monday, 16 November 2015 00:00. Posted in Co-Pay Program Optimization

adherence curve

For the last six years, we have been advising about the importance of understanding the patient adherence curve when planning co-pay programs. Understanding how your offer will impact patient adherence is of vital importance. This is an integral part of any planning process but you must start with a “clean curve”.

Take a look at your brand’s patient retention curve right now and you will probably see one that has two issues:

  1. It hasn’t been updated for a while
  2. It includes the impact of your current co-pay program (your base plus promotional business)

If you haven’t had your patient retention curve updated in a year or more, you should have it updated.   And when you are going through that exercise, you should get a breakdown of your curve without the impact of your co-pay program. Here’s why this is such an important exercise…

Once you have the curve that is free of promotional impact, you can use it to help structure your copay program. Most brands have one consistent offer for all fills but many times varying your offer at the right time or ending it earlier than 12 fills may be a better strategy.

You may find that your adherence rates have a steep drop-off for a patient’s first 3 fills but after that the remaining patients tend to stay on therapy. If you see a big drop-off from month 3 to 4 then you may want to increase your incentive for that use. And you might think about ending your offer once your patients reach that leveling off period.

In the end you will be looking closely at your retention curve and seeing how it is being impacted by the discount stimuli you are providing via your co-pay incentive program. If you have a good understanding of the adherence curve for patients not using a copay incentive, then you can more easily separate your base business versus the incremental business generated by your copay program.    

So, understanding your adherence curve is of vital importance as you plan your copay program. Having a “clean” curve will help you understand the real impact your co-pay program has on your business (true incremental business) and secondly, it will help you determine how your copay program should be structured.

 

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A Closer Look at Your Cap

Written by Al Kenney on Monday, 02 November 2015 00:00. Posted in Co-Pay Program Optimization

simk stopper

For many brands, the promotional offer cap is simply developed based on the budget number. Development of the offer (i.e.: pay no more than $20) is of primary importance and the associated cap is an afterthought. Based on our work optimizing copay programs we believe the cap is one of the most important parts of your copay offer.

The way you utilize your cap allows you to control your copay patient mix and cap your maximum liability. Caps can be structured in any number of ways: they can be different by patient type (commercially insured and cash) and by fill number (1 through 12). You can also have a “do not exceed maximum overall benefit” cap.

Here are a few things to consider when determining the cap for your copay program:
  • Cover 85% of patients to your “advertised” price - We have found that in order for your program to be most effective, your offer plus cap must cover 85% of patients to the price you show on your card. So if we used the Pay No More Than (PNMT) $20 offer and added a $50 cap per use, we’d be covering co-pays up to $70 and bringing the patient down to a $20 Out of Pocket (OOP). This will work well if 85% of the patients have $70 co-pays or less, but the program may suffer in the case where the average co-pay is higher and a greater percentage of patients have out of pocket amounts greater than the $70. For example, take the scenario where the average copay is $90, and 40% of the patients are above the $70 co-pay threshold. The program results will suffer because 40% of the patients will have an OOP more than the $20 noted on the card. The example I just gave features a “pay no more than” program. If you are not planning on covering a large percentage of your potential patient population to the advertised price, we would suggest that you utilize different wording for your offer (IE: “pay as little as” or “patient pays first” vs. “pay no more than”). This can help avoid patient confusion, but we have still found that patients rarely read the fine print and may feel tricked by the wording. In one case a patient actually reached the CEO of one of the largest pharmaceutical manufacturers and complained that the wording on one of their cards was misleading…it was changed rather quickly!
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Impact of Competitive Offers

Written by Al Kenney on Monday, 19 October 2015 00:00. Posted in Co-Pay Program Optimization

competition

How much impact do competitive offers have on your brand? This is truly a loaded question as each brand has its own unique situation and competitive environment!

The quick answer is that competitive offers certainly impact your brand but at different levels depending on the category and your position in it. What we have found is that most brands put much too much stock in their competitor’s offers which results in the brand overreacting with a more lucrative offer than is needed.

Every situation is unique and I’m speaking in generalities here, but we have seen that the bigger and/or more unique the brand is, the less impact competitive co-pay card offers will have provided that the brand’s offer is somewhere in the ballpark of the other offers in the category. This means that if you are currently at a PNMT $20 offer and your competitor goes to a PNMT $15 or even $10 you probably don’t have to worry. The reason is that HCP’s are still doing what they should be doing which is matching their patients therapy to the drug that they feel will do the best job.

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Escalating Your Patient Co-Pay Offer Over Time

Written by Al Kenney on Monday, 05 October 2015 00:00. Posted in Co-Pay Program Optimization

pill and dollar bill

An escalating co-pay offer is one that increases the longer the patient is on the drug. For example, this could be a “Save $20 on the 1st script, then save $30 on the second, and save $40 on scripts #3 through #12. Many brands implement this strategy in the hopes that it will increase adherence at the time the patient is most likely to discontinue therapy. It sounds like a sound strategy, but how do these escalating offers perform?

You might think that in order for this offer to outperform the single offer (For example, Save $20), the escalating offer would only have to increase adherence in a few patients. We’ve found that’s not the case. For the escalating offer to work from a financial perspective the offer has to greatly outperform the single offer on both an adherence and on a trial basis…and in our experience this rarely happens.

Your current program has patients using your non escalating offer (Save $20) and this is delivering a certain level of profitability for the brand. When you move to the escalating offer, you now increase the benefits for a vast majority of all patients currently utilizing your program. There is a lot of extra spending here which can only be offset by higher trial and adherence levels.

When setting up a copay program, brands need to try to avoid extending an escalating offer to patients with a high likelihood of filling the script. You can do this through your offer creation and this is the reason that PNMT, PALA, and PPF programs are so popular.

The new trial generated from the additional discount you now have put on the table to fund your escalating offer in most cases isn’t going to materialize to the level you need. You may see some increased adherence but it will be minimal and in most cases those extra purchases will not be enough to offset the extra cost of the program. You are simply paying out too much to patients you already had which puts you in a position that is difficult to make up. I’ll “never say never” as all brands and situations are different, but just know the odds are stacked against the escalating offer delivering a better ROI.

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Understanding Patient Offer Types

Written by Al Kenney on Sunday, 20 September 2015 00:00. Posted in Co-Pay Program Optimization

price too much to swallow

If you have been tracking offers lately, you may have seen a push away from “Save” or ‘pay no more than” towards “pay as little as” and “patient pays first” offer types.

Knowing the subtle differences between patient offer types can make all the difference.

I’ll take you through some of the reasons for these moves:

 The "Save" program

Here the brand has an offer that can be used by every patient that they deem "eligible", for example "commercial and cash patients". If you are eligible you will get the savings:

Pros - Every eligible patient receives financial assistance
Cons - Even patients who may have purchased anyway will receive this discount which will lower the potential for incremental volume and will reduce your ability to allocate funds to patients who really need it. In addition, what might seem to be an attractive offer (save $100), may backfire if patients conclude that your drug is too expensive
Best used for - #1 brand in category with great managed care coverage that just needs a copay vehicle for their salesforce.

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What About Cash Payers?

Written by Al Kenney on Monday, 07 September 2015 00:00. Posted in Co-Pay Program Optimization

pharm and patient

Should you extend a copay offer to the cash paying patient? The inclusion of a cash offer in a copay program structure is something that brands continue to struggle with.

Several questions should be considered when deciding whether your program should include an offer for the cash paying patient and how that offer should be structured:

 

What offers do your competitors have in market?

If your competitors all have very lucrative offers for their cash patients, it may make it impossible to get a positive return on your spend with this patient group. Sometimes it’s better not to be in the game if it’s not profitable for your brand. If few of your competitors have cash offers and they are not offering deep discounts, extending an offer to cash patients may be a strategy to consider.

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Attracting the Right Patient Mix

Written by Al Kenney on Monday, 24 August 2015 00:00. Posted in Co-Pay Program Optimization

mix of patients

Your copay offer can be a powerful tool for attracting patients to your brand. Understanding the potential patient groups that you can reach with your offer is critical to ensuring that you are designing the copay offer to attract your desired patient mix.

The first step is to segment the patient universe based both on brand usage as well as insurance coverage (or lack of coverage).

When looking at the category’s current patient universe based on brand usage we see the following groups:

  1. Patients who have been diagnosed but are not currently on any drug therapy
  2. Patients who are purchasing a competitive brand
  3. Patients who are purchasing your brand, comprised of:
    1. Offer Utilizers - those purchasing your brand WITH a copay offer
    2. Non – Offer Utilizers - those purchasing your brand WITHOUT a copay offer
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What is the Best Offer for My Brand?

Written by Al Kenney on Monday, 10 August 2015 00:00. Posted in Co-Pay Program Optimization

costlypill

This is the first first step necessary to develop the optimal copay program and offer for your brand -- the development of your objectives.

For years now, I have been asked the same seemingly simple question “what is the best offer for my brand?” The answer is simple… I know the answer is different for every brand as no two brands are in the same situation so I offer this response: “The best offer is the one that best meets your current brand objectives”. There is no one offer that works for everyone…never was…and there never will be. The key is being able to actually do the work to determine the best offer for your brand. This involves an in-depth analysis which most brands and vendors are not capable of doing themselves.

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Incented but Ineligible (IBI) Patients

Written by Al Kenney on Monday, 03 August 2015 00:00. Posted in Co-Pay Program Optimization

IBI patient

There is a major flaw in the way most companies evaluate their co-pay incentive programs and it can cause a brand to spend much more then they have to.

When it comes time to renew a program, a brand may choose to increase their patient incentive offer in an effort to increase sales.   The reality, however, is that more aggressive offers may generate more “claims”, but these offers may not deliver the desired impact on “sales”.  Analyzing co-pay programs based solely on the claims generated is not a sound practice and may encourage the implementation of increasingly more and more aggressive offers…eventually driving the offer down towards a $0 price point.

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What your e-Prescribing Vendor isn’t Telling You

Written by Al Kenney on Monday, 27 July 2015 00:00. Posted in Co-Pay Program Optimization

NCPDP system

There is a lot of push as an industry to move to electronic patient records. The e-prescribing process seems to fit that bill perfectly for the tracking and delivery of scripts to the pharmacy from the physician’s office. After all what could be better than an electronic file that will make tracking things like “written to fill rates” easy?

I'm sure you've all heard the sales pitch from vendors of e-prescribing solutions. One of their key points is: "We can deliver your co-pay offer directly to the pharmacy as part of the e-script". And you are thinking what could be better? Sounds like a guarantee that your script and offer get to the pharmacist at the same time. "This could increase usage of my program, increase adherence, and lower abandonment rates" you might be thinking. But there is a dark cloud inside this silver lined jacket.

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The Zero Copay

Written by Al Kenney on Monday, 13 July 2015 00:00. Posted in Co-Pay Program Optimization

blow out prices

Starting a patient off with a $0 copay for the first month of a new branded drug therapy has been a solid strategic marketing decision for a long time now. However, many brands continue to offer this discount year after year. Is this deep discounting a sound business strategy? Maybe…but certainly not always…

Starting a patient off with a $0 copay for the first month of a new branded drug therapy has been a solid strategic marketing decision for a long time now. However, many brands continue to offer this discount year after year. Is this deep discounting a sound business strategy? Maybe...but certainly not always...