One of the top three pharma companies in the US was looking to develop a playbook for appropriately handling the generic competition for their specialty blockbuster therapeutic. To do this, the company needed to update their internal practices for this specialty category – different from what they were following for other therapeutics – and refresh their playbook by conducting interviews with over thirty medical and pharmacy directors.
Irene Hunt, global pharmaceutical & biotech commercial subject-matter expert, conducted the interviews and presented her recommendations to the brand team in advance of any generic being approved:
- Advise specialty providers about instructions for “DAW” (dispense as written) &
90-day dosing options for branded renewal Rx
- Fax/email provider’s offices with an Rx renewal form for the branded therapy
- Email patients currently on the branded therapy that a Gx is coming and that the patients should talk to their providers if they wish to stay on their branded therapy
- Advise patients and providers to be aware of and to look for notifications by Insurance Plans of an upcoming switch to GX
- Advise patients of their rights and provide template letters/ language for
how patients can appeal decisions and how to request “Patient Prefers Branded” of their payer and from pharmacy
- Support providers and their offices by providing example language and other support via email or a portal, that can help the appeals process including template letters of appeal and example letters of medical necessity
- Ensure that pharmacy is aware of all the patient assistance programs
and charitable foundations that support the brand in order to help the patients manage the larger copay associated with the brand (post Gx)
As part of their Life Cycle Management plan, this playbook prepared the pharma company, specifically patient services and other customer-facing teams, to appropriately answer questions and best manage their resources through the most critical part of their brand development.