As is often the case, it’s not a single driver that shapes a trend but rather a confluence of many. Market Drill-Down takes current market data and driving the market.

Q: Is there a way for a brand marketer to track how many prescriptions go unfilled between physician office and pharmacy?

A: We often talk about lost opportunity in terms of what happens once a patient delivers a script to the pharmacist. Those potential sales can slip away in a myriad of ways, including payer rejection and patient abandonment, where the patient refuses to pay after learning cost of co-pay. We also often talk about lost sales after a patient is on therapy, due to lack of compliance and/or persistency. Until recently, however, it’s been difficult, if not impossible, to know just how many scripts never make it to the pharmacy.

All of these examples of lost opportuni- ty are like holes in a leaky bucket—there’s often more than one. It’s important to try to plug as many holes as possible to stem the flow. But, first you need to know the source of your “leaks.”

Many of the information companies that provide data to the pharmaceutical indus- try rely on claims data to help marketers understand more about their customers. Although this data is a powerful indicator, it has limitations, and by itself is incapable of answering your question.

With the increasing use of electronic health information, though, opportunities are opening up to better understand what slices it in new ways to reveal what’s really happens during the health care encounter. The ability to integrate many types of data is key to better understanding and managing your business. Data-analytics providers must be willing to partner with each other in order to expand visibility.

A partnership with a large provider of electronic health records, for example, is a way to provide visibility to what prescrip- tions were actually written in the physi- cian’s office. Integrating their records data with claims data lets analysts bridge the gap between physician records and the adjudication process to see just how many of these scripts are lost to “leakage.”

To illustrate how this new methodology works, we looked at some recent data for a brand-name pain medication. In the analy- sis presented in the graphic, you can see that for every 100 prescriptions written for the brand, only 39 made it to the pharmacy for an attempted fill. That’s pretty incredi- ble just by itself. We also see that of the 61 that did not get to the pharmacy, 22 were written for patients who had previous mar- ket experience—albeit in the pain market, possibly for a different condition.



If a marketer simply looked at the claims data, it would appear that it had captured one third of the patients and lost two- thirds of them to competitors, which is a fairly common split today. After seeing what really occurred at the prescriber’s office, however, it is apparent that the brand is capturing only 13% of the scripts written—thereby leaking an astonishing 87% percent of potential sales.

The pain-medication example helps illustrate how much work this marketer needs to do with doctors and patients to emphasize compliance. A review of other markets suggests that the opportunity lost between the physician’s office and pharma- cy can vary significantly. For example, we looked at the osteoporosis market, which shows an average of approximately 30% of scripts lost prior to getting to the pharma- cy. We also can see that individual prod- ucts vary significantly within that market.

As a result, opportunities lost at the doctor’s office may suggest different tactics than do opportunities lost due to payer blockages or price sensitivity. Using some of the current Rx compliance data can help you bridge the gap to understanding where the “leak” occurs and is important in stemming the tide appropriately.


  • Paula Fullman

    Paula Fullman is a Practice Lead with Source Healthcare Analytics, part of Symphony Health Solutions, where she is focused on patient, payer and provider analytics.


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