How to Measure Co-pay Program Outcomes

Let’s get one thing straight from the get-go: Co-pay programs are not cleverly camouflaged non-means-tested versions of Patient Assistance Programs. They’re not patient-centered give-backs designed to aggravate payers. Instead, thanks to the depth of actionable physician- and patient-level data they generate, well-designed co-pay programs are promotional resources that help move the pharmaceutical industry closer to true closed-loop marketing. Because of the rich data these programs yield, they can be as effective as many other promotional avenues at a fraction of the cost.

Every well-designed co-pay program is constructed with an eye toward the data it will generate. A host of fundamental outcomes metrics help brand teams answer the most basic question surrounding any program: “Did it work?” These include NRx and TRx, number of co-pay card claims, physicians using the program, managed-care wins, gross-to-net, etc.

Advanced Programs Provide More Insight

But today’s advanced programs provide deeper insight, tracking a range of valuable individual physician/patient behaviors (de-identified and HIPAA compliant):

  • Physician penetration benchmarking
  • Unique physician participation
  • Impact on prescribing
  • Patient enrollment benchmarking
  • Patient persistency

Once these data are collected, advanced analytic techniques leverage them so that ROI, promotional effectiveness and longitudinal indicators can be evaluated during and after the campaign. The rich data flowing from advanced co-pay programs add to already solid research showing that reducing drug co-pays increases adherence, improves clinical outcomes and even reduces total healthcare spending.

Outcome Measurements Are Necessary

Five key reasons why advanced outcomes measurement should be a part of every co-pay program are:

1. Co-pay is the perfect incentive to get patients involved and engaged to help influence outcomes. Why?

  • Patients share information in return for co-pay savings.
  • Incentives can be escalated in response to certain desired behaviors.

2. Co-pay programs’ data flow includes prescriber-specific information, pharmacy activity, refills/uses, out-of-pocket costs and claim reversal information. All contribute to a patient’s “outcomes measurement profile.”

3. Co-pay assistance helps smooth unpredictable managed-care landscape changes that derail good outcomes study design. With managed care coverage changing for a brand, thus causing patients to change/drop therapies, patient measurement over time may be lost. Co-pay assistance is designed to keep patients on therapy—even with the harsh cost challenges of higher-tier co-pays.

4. Co-pay data incorporated into the outcomes deliverables enhance the full story for an employer or payer. Enhancements include visibility to a combined matrix of disease-state effectiveness and financial measurement/monitoring. With financial monitoring as a component, outcomes by product (and even by disease state) are very telling.

5. Co-pay programs are available in a large variety of vehicles/methods, including traditional COB cards, Visa/MasterCard/debit cards, virtual cards, eRx-embedded offers, etc. All can be customized to fit the needs of outcomes-focused programs.

Every brand team should know today’s co-pay programs produce a much deeper level of longitudinal outcomes measurement. A team focused on outcomes measurement has many more—and more creative—options. It’s time to take advantage of the rich outcomes data your
co-pay program could be generating!

  • Chris Dowd

    Chris Dowd is Senior Vice President of Market Development at ConnectiveRx. In his more than 25-year career, he has become a recognized voice in the patient affordability and specialty medication arena, pioneering prominent copay and patient affordability programs, and creating innovative solutions for his clients.


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