As health insurance premiums and copayments have increased, patients are changing how they choose treatment options.

The old model of DTC was “raise awareness of new drugs with TV and send the salesforce out to promote the drug to HCPs. While some pharma companies are sticking to that model, it isn’t relevant anymore.

Last week I sat in on several focus groups via video conference, and it was the first time I heard research panelists talk about the cost of prescription drugs and new drug side effects. What really surprised me was that even if their doctor recommended a specific drug, patients said they would do research on it before filling it.

During the research, we were chatting among ourselves online, and there were a lot of “wows.” The Senior Director said, “the market has really shifted.” That’s a pretty good summary and was the title of my key findings PowerPoint.

So let’s try and make sense of what we found out…

1ne: Most health insurance is through employers (85%+) and rates have continued to go up. Employees ask, “what am I getting for my money?”.

2wo: PBMs and insurers direct patients to their preferred treatments by asking them to pay more for some new drugs.

3hree: While trust in pharma seems higher, it must be contextualized. They trust pharma to develop drugs but don’t trust pharma when pricing and marketing these drugs.

4our: PBMs are feeling the heat. Patient copays and coinsurance are based on the higher list price, not the PBMs’ discounted price. So patients can spend hundreds of dollars more out of pocket each year than they would if they had access to the discounted price at the pharmacy counter. Patients are becoming more aware of this, and it affects their decisions.

5ive: Those pesky side effects. At several groups, panelists mentioned the new “diet drugs,” but it wasn’t positive. Many panelists said they were afraid to try the new drugs because of the buzz around side effects on social media. In every group, the side effects of new drugs were mentioned.

6ix: The moderator did a great job talking about DTC TV spots. In summary, what we heard was there are too many of them, and they repeat too much. Those who said “they may be interested in a new drug” said they would go online to learn more.

7even: People are looking to online pharmacies and prescription drug savings sites to save money. Some mentioned that Good Rx and Amazon had saved them substantial money, and they don’t understand why drug companies can’t just offer them the lowest price.

8ight: Boomers, who are at the age when they use multiple Rxs, are more likely to search online for lower prices on prescription drugs.

If I had to summarize all 12 focus groups, it would be, “it’s my money, and I want to have more of a say about how much I spend.”

If I were leading a DTC brand, I would ensure that our messages encompass the advantage of our product over competitors in terms that patients relate to. For example, having lower cholesterol may not be enough of an incentive if your treatment requires more money out-of-pocket and infusion.

These finding are not applicable to every drug category but clearly show shifting attitudes towards DTC ads.