Managed Healthcare Executive recently published an article entitled "The Future of Formularies".  The article states that specialty drugs are expected to account for 50% of all drug costs by 2018 and that formularies will hold more relevance and impact as the number of older adults and insured individuals through the Affordable Care Act increases.


Pharmaceutical companies must begin to adjust their communication strategies around these future changes. A few areas that will see the greatest impact are targeting disease communications to unknown patients, contributions in the offloading of medication costs, and reinforcement of medication adherence.


Below are recommendations on how pharmaceutical companies can begin to address those challenges.


Disease Awareness Targeting

When reviewing and analyzing the future trends in formularies, John Mackowiak, VP Pharmacy  and Education for the Academy of Managed Care Pharmacy, emphasizes the need to focus on diseases awareness targeting.


"Tier 5 is extremely costly but may save money in the long run.  For example, the new Hepatitis C drugs may prevent a costly liver transplant; on the other hand many will live with dormant Hep C and never need the new medications.  How do we find out who needs these drugs and provide them in the nick of time to offset expenses?"


Pharmaceutical companies must have technology in place to capture disparate data as well as staffing that can make sense of it. Pharmaceutical marketers must succeed at driving strong inbound traffic through the development of disease education content.  Marketers must convert that inbound traffic through affordability and adherence programs on patient portals.  And further communications must be segmented, targeted, and personalized to the Digital Body Language of each individual patient and caregiver.  And this must all be accomplished in real-time. 29-01how-healthcare-reform-helps-savvy-article-3773.jpg


Medication Affordability

According to a report by Consumer Health, it's estimated that 46% of the people in the United States take at least one prescription drug. This means that there were 3.3 billion prescriptions dispensed in 2006. The total cost of all of these prescriptions was $192 billion. The average cost to fill one prescription with a brand name drug is approximately $111.02, while a generic prescription averages $32.23. This means that you would have to pay over THREE times as much for a brand name drug than as a generic one.


Pharmaceutical companies must educate the patient and the physician on the efficacy of their drug, as well as provide cost-alternative solutions. By providing physician and patient discussion guides around efficacy and drug alternatives, as well as providing co-pay programs, pharmaceutical companies can gain awareness and favor with both physicians and patients.


Bob Taketomo, President of Ventegra, recommends "adopting strategies to keep drugs affordable, while ensuring that patients can access what they need -- a move toward more deductibles, out-of-pocket maximums and flat co-payments, along with stronger management of deductibles and coinsurance."


Leverage co-pay programs. There is an 18% increase in adherence when co-pay programs are offered.  Utilize patient portals as places to educate as well provide opportunities for patients to request samples, coupons, and co-pay programs.  With the change in formularies there will be "additional emphasis on co-payments, along with stronger management of deductibles and coinsurance".


Medication Adherence

Pharmaceutical companies recognize that there is a lack of medication adherence. They must develop communications that generate awareness of medication compliance and tools available for healthy living and disease management like medication tracking tools.  They must work with HCPs and payers to communicate the risk and rising cost impacted by non-adherence.   This is especially true when targeting the use of expensive specialty drugs.


Pharmaceutical companies must give consideration to developing healthy living communications that educate both patients and caregivers on proper dieting, exercising and taking medication.  These communications should be very specific to the disease of the patient.  Companies should also provide a medication notification form.  This form should allow patients and caregivers to set-up alerts for medication email reminders.  It's also important for companies to leverage multiple forms of communication.  Extend beyond email and leverage other tools like SMS.  These SMS communications, much like the emails, should be sent regularly, based on the medication notification form submission, reminding the contact to take medication as indicated.


David Calabrese, RPh, MHP, VP and Chief Pharmacy Officer, Catamaran states, "We manage drugs from an overall care management perspective and if consumers receive what they need, take them correctly and receive appropriate follow-up, medications can deliver value".


How is your company preparing for the future of formularies?