So you spent a lot of time and money getting your target audience to ask for your medication and get an Rx, but that may not be enough. Some insurers want to talk to the prescribing physician to ensure that they have tried generic medications first and to understand why the physiciam is prescribing a branded medication. DTC marketrs need to understand the potential barracades for patients seeking branded prescription drugs.
If a patient asks his, or her, doctor for medications like Crestor, Lyrica or Cymbalta there is a good chance that insurers are going to step in and ask your doctor if other, less expensive, therapies have been tried first. I found this out when my doctor prescribed Lyrica for nerve pain as a result of trauma. The insurance company wanted to talk to the doctor to ensure that a full regimen of the cheaper generic medication had been tried first. The result was that I had to wait an additional day for medication I needed to control pain. If Pfizer had made me aware that this might happen I would have asked my doctor to call my insurer first.
The same thing could happen for drugs like Crestor or Cymbalta. Insurers are going to want to know if generic medications have been used first line and in fact some insurance companies may even tell patients that they can’t use their physicians anymore or go to a local hospital for non-emergency healthcare treatments.
What does this mean for DTC marketers?
1. Information should be provided to the patient about which insurers allow Rx’s of certain medications along with possible generic alternatives. Patient’s are going to find out anyway so help them navigate the system.
2. Work with insurers to understand the requirements to get an Rx branded drug vs. generic and use that information to help position your product.
3. Allow patients who have received an Rx, and can’t get their Rx filled because of insurers, to call a toll free number to help them get the medication.
4. Ensure HCP’s understand which insurers will allow them to write your product and which ones will not. It could save precious time and help patients get the medication they need.
Any delay in patients getting their medication could result in another day of suffering with chronic conditions. For me the nerve pain associated with a broken bone in my shoulder led to a slow journey into another day filled with pain. I had to make a lot of calls to get my medication and I wondered how many people would have simply given up and suffered rather than deal with a healthcare system that puts costs above patients. Kudos to the pharmacist at Right-Aid who pushed this Rx through the system for me.