5 Dos and Don’ts in Your New Copay Program’s First Weeks

5 Dos and Don’ts in Your New Copay Program’s First Weeks

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It’s 2018! This time of year brings a fresh new puppy calendar, a month of writing 2017 when you really mean 2018, and for many brand managers, a new copay program. While not every brand starts a new copay program on January 1, many do, so here are a few things to think about as you watch the results from your program come in.

1. Don’t panic at initial copay program costs.

I know, I know — the average benefit looks high and if this trend continues, you’ll blow your annual budget before you even start planning for 2019. But fear not, this is just because of the prevalence of high deductibles early in the year.

We’re sorry to say that because of increasing cost shifting to consumers from employers, it is likely that your copay program this year will be more expensive than last year. However, if your copay partner worked with you on accurate projections for 2018, you should have the higher early year cost baked into your estimates already. So while it might look scary, it’s all part of the plan.

2. Do track that abandonment rate like a hawk.

Deductible season is a risky time for pharma because the high costs can lead patients to abandon scripts. Your patient access program is here to help. Make sure it’s doing what it needs to do — helping new patients start therapy and keeping existing patients from switching, even though they may have a greater cost share early in the year. When looking at abandonment rates, don’t be fooled by averages. Make sure you and your copay partner are looking at patient subgroups to determine what is driving increased abandonment rates. Is it just deductible patients that are walking away at higher rates, or is there another group of patients you need to address?  

3. Don’t worry if you lose a few scripts.

That being said, if you lose a few scripts, it will be okay. Every brand has a unique strategy. However, very few brands really need to be in a “fill all scripts at any cost” mindset (we’re looking at you, launch brands entering a crowded market). If you aren’t one of those brands, remember that your copay program is designed to help patients who need a little extra help to fill, but not to buy down prescriptions so much that they actually cost more than the brand makes. That might mean you do lose a few scripts and that your abandonment rate isn’t 0. But that’s OK! Even if you see a small amount of abandonment, it’s still in the best interest of your brand.

4. Do dig into the details to understand what is really happening to patients at the register.

If patients are walking away, why is that? Are there reject codes driving their behavior, or is it just the cost? Maybe payers put in more prior authorizations this year and that is why the abandonment is higher. Or, if you find that the abandonment you are seeing is not driven by reject codes and instead seems to be driven by price…

5. Don’t be afraid to make changes to your copay program.

You and your copay vendor do the best to predict what is going to happen in the new year when setting up a copay program in the fall. You incorporate expected changes, estimate how employers will shift cost to patients, anticipate competitor behavior and base your program off of these forecasts.

But if your copay program data shows a higher than predicted abandonment rate early in the year and it isn’t aligned with your strategy, don’t be afraid to quickly change your copay program to accommodate the new landscape. If your vendor set up the terms and conditions correctly, you should have the flexibility to make these changes quickly without having to print new cards or do anything else disruptive in the field.

2018 is finally here, and who knows what it has to bring. The key thing to remember is to stay vigilant with your copay program and continue to monitor, track, and optimize to keep your patients – and brand – healthy throughout the year.

Talk to Truveris about optimizing  your copay program for 2018

Topics: Trends, Insights & Analysis, Pharmaceutical Manufacturers, Copay Programs

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Truveris Team