Breitstein: How must pharma change its interactions with audiences?

Saatsoglou: Certainly, our industry does not do a lot of research with seniors—not in terms of clinical studies or spending a lot of time talking to them as consumers. With Medicare, the challenge for marketing executives is to communicate a simpler message to seniors, which are maybe two or three generations removed from that audience.

Kalb: When you think about the elderly population, it's wise to think about their network of contacts. Most folks over age 65 don't use computers too much. It may actually turn out that companies' marketing efforts should be directed toward their children and grandchildren, at least for the Medicare enrollment.

Vanderveer: As we move in that direction, the amount of information that physicians must access and use will multiply. How they're going to manage that information is highly problematic. Rather than wasting their time with repetitive detailing, we're going to have to help the pharmaceutical industry help healthcare professionals to better manage information.

Unraveling the Medicare Mess

Clinton: How are companies assessing Medicare's impact?

Brodsky: We need to get the enrollment data quickly so we can track what's going on. I'm not convinced that accurate data exist at the patient level regarding who is a Medicare beneficiary and who is not. Misattribution of Medicare enrollment could make it seem much smaller than it actually is. It will take a while to sort that out.

Slack: One of the difficulties is in forecasting when and how many patients will enroll in the program, largely because the eligible patients may not be ready to make their decision. So we're trying to understand something that hasn't yet been decided on.

Fox: Companies can conduct risk assessment based on demographics like patient age and their current [prescription drug coverage] plan, not just enrollment. Assessing the risk of the market base—how many patients are on which products—is likely to determine if changes to the brand strategy are needed. The next step is to understand what doctors and patients will do when they hit the doughnut hole—that's a research question, not so much a data question.

Bajpai: Some people are going to hit the doughnut hole in February and March because they take very expensive products. But we do have some ways of estimating those numbers. Everybody is developing a scorecard, some kind of a flag identification system, some kind of support system. Everybody is looking at it from a forecasting perspective and lots of people are nervous about whether they will meet their business unit's targets and goals for the year.

Saatsoglou: The complicating factor is that, as we have seen in other countries, those with the highest level of need get into the program first. The cost per person is very high to begin with. And that's why everybody's striving to enroll as many people as possible in the program to leverage the cost. We all know there is a provision in the MMA bill that says in two consecutive years, if 45 percent of the bill is not paid out of general revenues...then the bill goes back to be re-evaluated by legislators. Which then brings us back to the questions: What is the cost of the bill? And what is the pricing that the bill assumes?

Kalb: Later in the year, it may turn out that AARP takes a position on whether or not that original vote should continue to be supported. The November elections could wind up moving one of the two houses or both houses to the Democratic side. If that were to occur it would be a precursor to the 2008 election. So you may soon see changes in the law that could have an impact on all the details you just described.