Understanding Rx Processing
Pharmaceutical companies invest heavily in marketing efforts to recover development costs for their brands. It’s important for these manufacturers to understand their brand’s journey through the Specialty Pharmacy – isolating leakage points that either slow down the dispensing flow or halt it altogether. Specialty Pharmacy is pivotal to understanding the leakage points since they are the last point of contact with prescription. Learning decision points and barriers to dispensing is key, including these pain points for dispensing:
- Formulary; prior authorization (PA) requirements
- Closed distribution networks
- Turnaround time – from the time a patient is enrolled to the time the patient receives their prescription
- Insurer and prescriber interactions
500 prescription records were collected from specialty pharmacies for the client brand and competitor scripts. Each record included how the prescription was written and dispensed, turnaround time, adjudication details, and dialog between HCP-Insurer-Patients that influenced the dispensing outcome.
Research revealed that the brand experienced barriers to dispensing, with the prevalence of PAs being the largest hurdle to onboarding patients. Delays ranged up to 5 weeks to onboard the patient and necessitated multiple touchpoints between the pharmacist and HCP, Insurer, and patient. The client was able to address distribution networks and quality of the relationship with SPPs to expedite onboarding going forward.