Copay Programs—Beyond Patient Adherence

Abstract 

Outsourcing is no longer focused only on ‘cost-cutting’, but rather, improving performance of pharmaceuticals, and novel means to retain their share in the market. A copay program, one among such initiatives, is driven by a need to increase brand loyalty, and enable access to drugs for a specified population of patients. Companies prefer copay as a patient adherence tool in order to increase the footprint of branded drugs. 

These programs, provided to those with private insurance, act as a platform not only for patient adherence, but also an indirect advertising means for prescription drugs. Thus, pharmaceuticals need to focus more on sustenance of such programs with a multifaceted approach, keeping in mind the various challenges posed by regulations and payers, while increasing their market share. This article focuses on various challenges in this particular landscape, and how sustainable copay programs could possibly be achieved by Procurement Organizations. 

 
Introduction 

In 2015, Pfizer spent $20 million on copay programs. Considering the U.S. market, this number contributes to 40 percent of the global spend. More than $309.5 billion was spent by patients on prescription drugs in 2015, which is expected to reach $370–400 billion owing to the increased enrolment of citizens under various medical insurance policies. 

Drug manufactures run in-house copay programs or outsource such services to suppliers in the market. The copay supplier community is heterogeneous, with suppliers from both clinical development, and pharmaceutical sales and marketing companies. Companies prefer to work with a mixture of preferred and local supplier mix depending on the geography and service required. This is combined with a projectbased approach, considering the small-term requirement for a particular drug or therapy.