LET'S FACE IT: NO BRAND MANAGER WANTS THEIR DRUG LISTED ON THE THIRD OR FOURTH FORMULARY tier. But the reality is that brands
often do wind up with low coverage, making them more expensive for consumers. So what should companies do when that happens?
Pharm Exec's George Koroneos asks 10 industry experts the question that's stumping most pharmaceutical marketers:
Q: "How do you persuade providers to prescribe drugs that have significant formulary restrictions, or are not reimbursed by
managed care organizations?"
There have been examples where managed care plans move a drug from tier two to tier three, and suddenly the patient is paying
$25 more a month for medication. In these cases, manufacturers should minimize the payment for the consumer by specifically
designing coupon programs that help pay for the managed care rebate differential. Coupons are a great way to help patients
stay on the drug, particularly if they're responding well to that agent. Generally, coupon programs do not have incredibly
high redemption rates—but it is high enough to bear out a pretty dramatic increase in patients' persistence for our products.
JAY CARTER, senior vice president, director of client services, AbelsonTaylor
FOCUS ON FORMULARY
Sometimes physicians think a drug isn't covered and it is. One obvious marketing strategy is to arm the sales rep with a grid
of the formulary positions in their region. Or, if a lot of patients are on consumer-directed health plans like health savings
accounts, reps can help show doctors how patients can cover the costs, such as flexible spending accounts using pretax dollars.
If you educate physicians that it's not always all out-of-pocket, then they don't feel quite the same guilt [when they prescribe
a more expensive brand]. When it comes to sales materials, it's all about showing the overall efficacy.
ANNE STUCHINER, vice president, director of customer segment marketing at DraftFCB
DISCUSS SIDE EFFECTS
Marketers must find ways to make doctors understand that when patients switch brands, they may end up with side effects that
are more than a nuisance—they can be really painful and disruptive. There are many co-pay reduction programs that are effective
in many categories, particularly in chronic conditions. We are working on a program where a co-pay reduction card is in a
kit that the doctor distributes. The patient brings the card to the pharmacy with their prescription and they get a discount
off the co-pay to make up for the cost differential.
RISA BERNSTEIN, Flashpoint Medica
Agencies must identify very clearly what the benefit of the drug is relative to other options. In some cases, depending on
the drug, marketers must identify the particular patient population for which it's most appropriate. Marketing an expensive
drug is the same as marketing any other—even a breakthrough oncology drug requires a thorough understanding of the unmet medical
needs in a category. The patient deserves full disclosure on why a particular drug is on the market, being prescribed, and
what is it going to do for them.
JANE PARKER, group president, Grey Healthcare Group Worldwide