Diagnosis
You have a wide territory and need to identify your best prospects
Prescription
The opportunities are there as long as you understand the data
You are responsible for calling on hundreds of physicians spread out within a 50-mile radius. Your top competitor just went
generic at the end of August, and two out of every three managed care plans across the country have moved your product from
tier 2 to tier 3 and are requiring prior authorization. What are you going to do? How are you going to grow sales of your
product when faced with these odds?
Don't fret. There are opportunities. You just have to find them. Then you have to develop appropriate messaging to maximize
those opportunities.
Data-based analysis
Finding opportunities in your territory requires research on your physician customers as well as on the healthcare plans that
have enrolled most of their patients.
Physician data you will need include:
- Physician prescribing volume
- Payer mix
Healthcare plan data you will need include:
- Formulary position of your product and of your competitors' (tier 1, 2, 3, 4; preferred/nonpreferred; on formulary/not on
formulary)
- Restrictions placed on your product and your competitors' (prior authorization, step therapy, quantity limits)
By analyzing these data, and cross-referencing them, you will be able to pinpoint opportunities.
Consider Dr. Joel Cathaway (a fictional physician created for the purposes of this article). Dr. Cathaway has a large practice
and is among the top-20 prescribers of your product in your territory. The data in Table 1 show Dr. Joel Cathaway's payer
mix and prescription volume in August and September, similar to data that may be provided to you by your company. This table
shows that Dr. Cathaway's top payers collectively account for 56% of his prescriptions written for your product. Aetna and
Cigna are at the top of the list, accounting for 17.1% and 15.3%, respectively.
The data also show Dr. Cathaway's prescribing volume for the months of August and September of this year. These numbers show
that the newly launched generic version of Competitor 2 is cutting into sales of your product. Dr. Cathaway wrote your product
146 times in August, but only 131 times in September. Meanwhile, his patients filled 90 prescriptions for the generic in September,
up from 5 in August, and that low August number is probably because the generic was not available until the end of the month.
Formulary position, copayment and restrictions
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The numbers seem to indicate (although this is total Rx data only) that Dr. Cathaway is writing new scripts for the generic
product, while he is keeping his patients who currently take your product on your product. If your company provides you with
new prescription data, all the better.
Now, consider the formulary position of your product and your competitors' at Dr. Cathaway's top plans. To locate this information,
you will need to look within your own company's resources, and perhaps beyond those resources as well. Many managed care plans
make their formularies available via their websites. If your company does not provide you with formulary information, try
the websites of prominent plans in your territory.
Once you have gathered formulary information on your product and your competitors', you can organize it in a table, such as
that shown above, including formulary position, and data on your product and your competitors'. The table illustrates that
your product still enjoys tier 2 formulary access at several of Dr. Cathaway's top plans, including Aetna and Healthspring.
Aetna accounts for the highest percentage of payers at Dr. Cathaway's practice, at 17.1%, while Healthspring accounts for
8.2%. With respect to Aetna and Healthspring patients, you may have an opportunity to counter some of the damage your product
has sustained due to the introduction of a new generic in its class.
