The rewarding payback for brands that rethink cost assistance program engagement

Even though medical care levels are returning to pre-pandemic volumes, treatment costs continue to rise, driven by factors such as the growing cost of medical care, increased utilization, and later-stage diagnosis of illness.??

Drug affordability, pricing transparency, copays, and adherence continue to affect the industry and, more importantly, patient outcomes.??

Unfortunately, many HCPs are not talking to their patients about the cost of the medications they are prescribing.? A study in JAMA in 2021 showed only 21% of HCPs could accurately estimate out-of-pocket drug costs using information about the drug’s price and an insurance plan’s cost-sharing mechanisms (including deductibles, copays, coinsurance, and out-of-pocket maximums). This indicates that few physicians can have informed conversations about financial trade-offs with their patients.???

The result is that patients can experience “sticker shock” at the pharmacy, which can lead to prescription abandonment.? A Kaiser Family Foundation study found close to 30% of adults report not taking their medicines as prescribed due to cost. With increasing pressure on value-based care, life science companies may be minimizing a major contributing factor that impacts treatment and health outcomes—cost education and copay programs.??

Currently, overall patient awareness and utilization of copay assistance programs is low. A strategy for more continuity between patients and HCPs (and, to some degree, payers) would be to increase efforts around copay assistance education and service improvements.

Four opportunities to consider:?

1. Rep-delivered cost education: Teach reps to engage HCPs and staff through repeated conversations about copay offers. While efficacy and safety are usually a primary focus, discussing copay assistance and cost education can create jumping off points on other key topics and messaging.??
2. POC digital enrollment: Leveraging EHR and QR codes to simplify digital patient registration digitally at point-of-care to increase enrollment into manufacturer programs. Reducing barriers to sign-up helps ensure patients can fill their prescriptions, but it also can open the door for brands to directly communicate about treatment and adherence.?
3. Eliminate one-size-fits-all: Investigate program customization opportunities to better meet individual patient barriers and needs.? Developing different assistance program options aimed to meet relevant individual challenges can reduce abandonment, help with adherence, and lead to better brand experiences and health outcomes.?
4. Customer journey data: Use health data and qualitative research to find key moments in the patient journey to improve assistance program interventions, encouraging both initial and supporting fills. Most journeys focus on the diagnosis phase, but the investment can be lost if the prescription is abandoned in the end.?

At DiD, part of the Lucid Group, our deep expertise in influencing HCP and patient behaviors can help you rethink promotion or structuring copay programs and HCP focus cost education for greater success.??

Contact DiD to learn more?