Building on Awareness to Improve Brand Adoption and Conversion Rates

Vickie Andros and Jake Caines discuss how to identify and overcome barriers that keep prescriptions from getting to the pharmacy, and most importantly, to the patient.

Building awareness for life-changing pharmaceutical therapies is a primary focus of the brand team and is an activity at which brand teams are extremely adept. However, investments in activities that successfully build awareness and aspire to ultimately deliver positive patient outcomes frequently come up against immediate barriers to getting prescriptions filled. Increased brand awareness is of minimal benefit to the patient and manufacturer if prescriptions don’t make it through the pharmacy intact, or indeed from the pharmacy to the patient. This piece focuses on current barriers that prevent prescriptions for branded medications from getting from the provider through the pharmacy and to the patient, and it proposes several solutions for overcoming these barriers.

ePrescibing is a powerful tool but barriers to getting the first fill still exist

ePrescribing is on the rise and is a good thing for brand managers. This method significantly increases the odds that prescriptions reach the point of sale over dispensing handwritten prescriptions to patients. Pharmacies are motivated to ensure patients pick up their prescriptions, and many use text reminders or phone calls to increase the likelihood this happens.

A 2015 study published in the Perspectives in Health Information Management found that among older adults, 81.3 percent of the patients preferred electronic prescriptions to paper prescriptions, and 76 percent said their physicians sent their prescriptions to their local pharmacy electronically. Nearly 30 percent said ePrescribing improved their adherence to medication, and more than 60 percent said ePrescribing improved the care they received from their pharmacists.

Still, from the doctor to the pharmacy, there are a number of possible impediments to branded prescription fills:

●     Prescription errors in strength and dosage.

●     Drug-drug interaction or contraindication.

●     Prior authorization or step edit requirements. While prior authorizations are intended to ensure high cost therapies are used appropriately, manufacturers have limited ability to track prior authorization processes and progress.

●     Generic substitution, lack of onsite inventory and non-formulary products.

From the pharmacy to the patient, things can also go wrong

Except for patients who receive prescriptions via home delivery, patients must show up at the pharmacy. It is commonly cited that 20 percent to 30 percent of medication prescriptions are never filled. The root causes of this are myriad and include:

• Financial: do patients have enough money to afford their co-pays/medications?

• Psychosocial: how are patients coping with stress, depression, homelessness?

• Lack of transportation: are patients able to get to the pharmacy?

•  Polypharmacy: are patients filling medications at more than one pharmacy?

•  Lack of education about the medication and its likely impact on the patient’s condition: do patients anticipate or experience unpleasant side effects?

• Stigma: do patients face stigma around their diagnosis that hinders them from getting the medications they need?

Any one of these causes can leave prescriptions unfilled or not taken as prescribed.

While no system or combination of systems can guarantee 100% fill rates, there are a number of solutions that can improve fill rates:

●     Persistence and consistency in prescriber relationships

Pharmacists are able to resolve prescription errors, drug-drug interactions and issues related to contraindications. The question to consider is are they able to be consistent and persistent in their approach? Pharmacists whose workflow allows them to re-engage prescribers consistently with requisite documentation, data and insights are an immensely valuable asset and source of alignment to the entire healthcare system, including brand teams.

●     Prior authorization management and benefits investigation strategies

Prior authorizations aren’t going away. Prescribers know this. If they believe in certain products, they will work hard to successfully satisfy prior authorization requirements. But in order to do so, prescribers must also be able to support associated investments in time and staff.

Brand teams, on the other hand, would be well-served to keep both prescriber and patient engaged and informed on the status of benefits investigation. Hubs and other organizations that provide benefits investigation and patient access support can affect positive patient outcomes, but the level of patient education and support among these programs vary, and the improved alignment and communication from all parties involved resulting from these programs vary as well.

●     Partners who employ multiple patient communication methods

The challenge of identifying and using patients’ preferred means of communication, be it phone calls, texts, mobile apps or some combination of these, rests with prescribers and pharmacy staff. Patients can be fickle; healthcare providers must be consistent and persistent in their outreach efforts, and the most successful providers accommodate patient communication preference.

●     Personalized patient education

Physicians in a study measuring the length of time spent discussing all aspects of new prescriptions and guideline-recommended aspects of counseling spent, on average, less than one minute on the topic. Lack of patient understanding about their medication is a key barrier to adherence. Therefore, healthcare providers should be available to answer patient questions and provide additional information, particularly in instances when new medication is prescribed.

In parts three and four of this series, we will explore answers to and mitigation strategies for questions like why don’t patients persist in their efforts to take the medication as prescribed?

About the authorsVickie Andros, PharmD, is Director of Clinical Services, and Jake Caines is Senior Director of Commercial Strategy and Performance, both at Curant Health.