Segmentation and Understanding Payers

ClientA mid-sized pharmaceutical company, preparing to launch a second in class product against an established brand, wished to make MCO access and contracting decisions and understand the need for and utility of patient financial support such as vouchers/coupons. 
Company ObjectivesDetermine the level of contracting and discounting needed for the market and the likelihood of the product to gain second tier formulary status.

What was more cost-effective in getting written prescriptions filled: preferable lower co-pay tier status or coupons?

Would these considerations and tradeoffs be the same in different health plans & regions?

Project DescriptionUsing primary and secondary research to determine the size of each plan opportunity, MME estimated the effect of gains in managed care access (with and without rebate) vs. gains from coupon/voucher program versus regular contracting.

Using this information, MME developed a desktop tool for determining the balance and trade-offs (in terms of both profitability and market share) of discount/rebate programs for preferable tier placement and coupons provided to patients/physicians.  By using the known or most likely response of the plans and their patients to these tactics, the client was able to develop specific plans for each account.

Project OutcomeThe interactive model helped the client to determine overall revenue projections under customized access scenarios, rebate levels, coupon/voucher acceptance rates at the physician and patient level, and ultimate cost differentials, which provided for a payer marketing and contracting plan that was aimed specifically at achieving the brand team’s goals for the product.