With more than 90% of covered workers now facing a tiered formulary for prescription drugs, patient out-of-pocket costs are more important than ever. It’s no surprise then, that copay programs have become standard patient support resources for biopharma brands. And while it may be obvious that patients greatly appreciate the value of the manufacturer’s copay support, thoughtful brand managers also keep a finger on the pulse of prescribers’ opinions.
As part of our ongoing research, ConnectiveRx maintains a sharp focus on prescribers’ experiences, and we’ve been tracking their opinions on copay support for years. In October 2019, we repeated a prescriber survey first fielded back in 2016, and the results show some prominent changes.
Key Finding #1: Prescribers reach for generics for first line therapy
However, they increasingly believe copay support helps them prescribe needed brands when managed care is restrictive.
When prescribers (MD, DO, NP, PA) were asked about their choice of medications for initial therapy, 74% reported that they choose a generic medication. However, when that is not adequate, they will choose brands. When asked about their perceptions of copay programs for brands, the answers to some questions exhibited uncanny consistency across the years. For example, 80% of prescribers in both 2016 and 2019 believed that copay programs are “an effective affordability tool, encouraging new patients to fill prescriptions,” and 65% in both years said these programs are “an effective adherence tool, encouraging patients to stay on medications.”
However, there were noteworthy changes in other areas. In 2016, 72% of respondents agreed that copay programs “help me prescribe when managed care is restrictive.” In 2019, that number jumped to 78%. This increase suggests that prescribers are recognizing the ways copay programs can help as they prescribe in a strong, managed care environment:
- To help prescribers and their patients have more complete information, patient savings offers can be delivered in the EHR at the same time as patient price transparency tools deliver patient-specific drug prices.
- Debit-card programs offer an additional way to provide patient financial support to eligible patients where cost concerns may be an obstacle. They can be loaded and reconciled to meet brand goals for helping patients get started and stay on needed therapy.
- Program business rules can dynamically adjust offers based on days’ supply, number of fills, NDC, step therapy, state, age, gender, annual cap, days between fills, etc.
- Copay programs can provide a bridge to help patients start therapy when a PA is required.
Key Finding #2: EHR delivery of coupons becomes prescribers’ #1 preferred channel
Together, the 2016 and 2019 surveys paint an interesting picture of copay offer delivery. First, the reported use of EHR coupon delivery doubled between 2016 (9%) and 2019 (19%). “Giving a printed coupon” dropped by more than 25% (see more on this in #3 below) and “directing patients to the brand website” saw an increase from 40% in 2016 to 49% in 2019.
The future of copay coupon delivery, however, promises to be significantly different. According to the 2019 prescriber survey, EHR-sourced delivery of coupons (send with eRx and send to patient portal) is trending up and is now the #1 preferred distribution method.
As shown in Figure 1, 58% of 2016 respondents identified in-EHR delivery as a preferred method, but by 2019 that number grew to 74%. Importantly, that 74% preferred rate in 2019 is the highest-rated of all delivery methods (Figure 1, magenta bars). Prescribers’ own words demonstrate the importance of in-EHR coupon delivery:
“My absolute preference would be EHR, in a streamlined and easy format; also that the pharmacy teams know and can access easily and equally for all patients.”
NP, Family Medicine/General Practice, Independent practice
“Ideally, I could be made aware of these when putting in prescriptions in the EHR.”
MD, Infectious Disease, Health system/Hospital owned practice
“Pop-up in EHR when prescribing a specific product that qualifies for the saving.”
MD, Pediatrics, Independent practice
“I need current information and availability by the easiest means necessary. I will not spend time to look this up for patients, to be honest.”
DO, Emergency Medicine, Health System/Hospital owned practice
Key Finding #3: Physical cards are important, but trending down
While prescribers’ interest in EHR coupon delivery is on the upswing, the opposite is true for hard-copy copay offers. The percent of survey respondents actually handing physical cards to patients dropped from 90% in 2016 to just 67% in 2019. Furthermore, only 37% of prescribers viewed physical cards as a preferred distribution method in 2019.
Conclusion
Taken together, these findings suggest that delivering copay savings offers in the EHR represents the future of copay. As described, prescribers prefer the EHR channel and the technology is readily available.
There is no better opportunity to ensure that your program is visible to providers, pharmacists, and patients than to deliver the offer in the moment your brand is being prescribed, filled, and delivered.