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Postscripts Rx
Conversations Beyond the Prescription. Where pharma, HCPs, life science and digital health solutions meets patients—after the script is written. Conversations on digital health, engagement, and real-world impacts that are re-writing the future of patient engagement.
Postscripts Rx
When Prices Equalize, Patient Experience Becomes the Battleground
Healthcare is undergoing a pricing revolution that will fundamentally transform how pharmaceutical companies connect with patients. The new Most Favored Nation model means Medicare will soon pay no more than the lowest price pharmaceutical companies charge in other developed nations – a dramatic shift from America's historical position as the world's most lucrative medication market.
What happens when price is no longer your competitive advantage? This pivotal moment demands pharmaceutical companies rethink their approach to patient relationships. With transparency revealing actual medication costs to both doctors and patients, and shocking statistics showing 57% of patients switch brands or abandon therapy within 90 days, maintaining loyalty becomes critical. The post-prescription experience – what happens after a patient leaves the pharmacy – emerges as the new battleground.
Digital engagement platforms like Medisafe are proving their worth as strategic assets in this changing landscape. By delivering personalized interventions at precisely the right moments, these solutions can improve adherence by 20-30% among active users. The most effective approaches create comprehensive ecosystems acknowledging that patients typically manage multiple medications simultaneously, offering integrated support that includes medication management, educational content, copay assistance, and direct communication channels with healthcare teams. When seven out of ten users engage daily, these platforms become powerful tools for preserving revenue and improving outcomes.
Forward-thinking pharmaceutical companies are already adapting their strategies, investing in U.S. manufacturing and accelerating adoption of digital patient support infrastructures. The fundamental question has shifted from how to launch successfully to how to foster lasting patient relationships throughout the entire treatment journey. When medications are priced similarly, the experience surrounding them becomes the true differentiator – transforming pharmaceutical companies from mere medication providers into genuine patient partners committed to better health outcomes.
PostScripts Rx is not intended to constitute medical advice, nor is it intended to influence prescribing decisions or any other medical or clinical decision-making. All medical and clinical judgment and decision-making, prescribing decisions, and all related considerations remain exclusively the responsibility of providers and patients.
Welcome to Postscripts, the podcast exploring what happens after the first prescription. We cover the latest innovations in patient access, support, digital tools, HCP engagement and pharma marketing that drive, we hope, better outcomes for patients. This podcast is for informational purposes only and does not constitute the giving out of any medical advice or should it be used to influence any clinical decision-making. Patients should always consult their healthcare professionals. Welcome to the podcast. My name is Brian Carr from the Medisave team, and although any opinions expressed here are expressly my own and not those of Medisave or its partners. So let's take a look at the new pricing paradigm. This is pharma's pivotal moment. With the recent executive orders by the administration, they're invoking what they're calling a most favored nation pricing model for prescription drugs. Here in the United States this is outlined in the Making America Healthy Again initiative and covered by CNBC and others where this is under the MFN model, which is the most-favored nation, that Medicare plans and the patients for them would pay no more than the lowest price. The pharmaceutical companies are charging in other developed nations, such as Germany, canada, uk, et cetera, and that sounds great for patients in the system at face value. But look for pharma manufacturers it could have a seismic impact on the revenue structures, their future commercialization strategies. So in today's episode we really want to explore how the new pricing policy in this environment could accelerate the urgency for pharma to really double down on brand loyalty, right. So patient persistence and even digital engagement to keep that loyalty top notch, and patient support. So we're going to dive into tools and digital platforms like Medisafe and others and really can help pharmaceutical brands maintain their relevance and revenue amid real volatile but really competitive pricing for medications, right. So a couple of things. Also in the executive orders that were put out by the White House, some other things didn't get as reported as much. One of them is the transparency of medical records. So what this means is pharma will now have well, not pharma necessarily, but doctors, hcps, patients will have much more transparency into what the actual retail price of the medication is and being charged through Medicare to the patients. So right now, doctors don't know how much medications necessarily cost when they prescribe them. They're actually going to see those results. You can imagine patients as well are going to see those prices and say perhaps, hey, no-transcript, and I know I'm not going to. I've already been taking the medication for a while. There's no reason for me to switch. I don't feel side effects et cetera, et cetera. Right, so you may have that increased need for a farmer, push that. But we're calling the post script. After that script is filled, it's not necessarily going to be all about the new prescriptions being filled now and that's your metric and your KPI going forward. If you're a brand manager, it's going to pricing that loyalty could actually have. It has an impact now, obviously, that persistence and adherence, which translates into brand loyalty, but putting more effort and perhaps marketing effort into protecting that market share in a price war environment is definitely going to come to the fore.
Speaker 0:So you know the US is historically the world's most lucrative market for medication sales. You know the US pays on average, depending who you talk with. You know Congressional Budget Office reports it's two and a half times more for prescription drugs on average than other high income countries. So you know if you reference in the end. The other thing that went unreported was in the EU trade agreement that was reached with the administration. They actually opened up a bullet point in their announcement that the US would, for the first time ever, follow the pricing protocols that are already in place in Europe where European countries look around to the neighboring countries for the pricing impact right and what they think they should be paying in their country for the medications. That's something the US has always resisted. They did not compare prices worldwide for their own US-based medication pricing, but what happened was in the EU trade agreement for tariffs they went through. Keep an eye on what they're saying about drug pricing in particular, because they've already put in that they will open up the U? S to also look at the prices in all the developed nations. That was something that was never, never done in the past, and now is wide open as a, as a standard right.
Speaker 0:The no-transcript loyalty play when patients really have generic or biosimilar options but they're priced similarly across the board, right. So there's two things here. One, if one medication is priced significantly lower and you're seeing campaigns and ads for that, hey, why don't you switch over to this medication? It's a lower price but you're used to the one you have, you're comfortable with the one you have. You want that brand loyalty right, and we see that. You know, in the United States we'll see it all the time. You can go to a for a home shopping, you can go to a Home Depot or you can go to a Lowe's. You reasons, right, you really, you know, ideally maybe they're same on some things, but there may be things that one company carries that the other one doesn't. So we see that all the time in the US and there's reasons why brand loyalty is such a big component of our culture here. Right, you know it's been a challenging concept when you transfer that into pharma. Right, patients really don't choose their meds, right, like they choose their smartphone or their you know, their home, whether they go to Home Depot or Lowe's. Right, but with today's commoditization is what it is.
Speaker 0:On pricing, you know it could be that you want to create a meaning, more meaningful relationship with patients is going to become a strategic imperative. When you look at the, there's a report by the Drug Channels Institute that came out in 2023, and it said that up to 57% of US patients switch their brands or drop therapy within 90 days of getting new prescription. Right, so for therapies that keep relying on those refill rates, this can be a crisis of continuity. Now the issue there is some of that's already baked into forecasting for pharma models and brand managers. They'll tell you that, right, a lot of it is about we want to get new prescriptions in, because we've already built into the model. While we know there may be some churn after 90 days, that's a historical trend. However, the brand protection and market share to go address that churn is going to now increase in value if the pricing is now a variable that people are putting into account.
Speaker 0:So you know, pharma has long prioritized market access, prioritize market access, but when you consider it in this new landscape on pricing, a real differentiator could lie in post-prescription support, and we know that. We see that at Medisafe, because we see that successful patient outcomes it's not just delivering the pill, it's about aligning the right behaviors, getting the right nudges at just the right time for certain patients, very highly personalized, based on billions of data points. We've collected, at over 10 years, anonymous data points from people on certain medications. We know exactly what trends to watch out for and give different nudges at different times that we know will be more effective to keep patients on treatment. So you know we've got a digital companions and other platforms that you may speak to this as well. We've got plenty of different.
Speaker 0:One of our major differentiators, though, is our adjusted time interventions right. So, because we have such a large data set. We've actually done lots of testing and optimization based on the best and most effective ways to communicate with patients who may have fallen off treatment, or also you know they need to refill right, so we have got many you know alerts and you want to make sure refill is a crucial time for patients, so you're getting them at the right time. You've got 10 days to refill, et cetera, et cetera. Make sure you do it. So that result is massive engagement. I will tell you, in our platform, of those people who visit us on a monthly basis, seven out of 10 are engaging at least once a day. So more often than not, they're doing more. They're on five or six different medications, managing them throughout the day. So what you see? There is deeper engagement. You're going to have higher refill rates if you engage patients after that script.
Speaker 0:And, frankly, you can get a stronger emotional affinity with a particular brand if prices are equal across all alternatives. Why? Well, you may have, especially for rare disease. You have a major patient support system that's supporting patients. I mean, especially for rare disease. You have a major patient support system that's supporting patients and you know that. Hey, you can tap within your digital environment and you can get right in touch with your patient support program caregiver, nurse, like that. Hey, I've got a question about my refills. I need to re-auth. You know you've got digital copay cards now that are involved in the Medisave platform. I'm going to actually tell you what your balance is in your copay card. Is in your copay card? If it's running low, you can tap, talk to your patient support team. Hey, I've got another refill due, but it looks like my copay card has run out. Can you do anything to help me in that support? So that type of engagement is certainly going to be enhanced with price controls, right, and really deliver ROI for pharma partners, because obviously it's easier to keep someone on path on medications and have those better impacts than we all hope happen as opposed to well, give me a reason to switch. And I've heard about this other medication that doesn't cost as much, right? So you know the whole acquisition cost model. You know it's tougher to more expensive to acquire a new patient than it is to actually keep on treatment, and that's going to be a lot more of a focus when we talk about brand loyalty, which is really my world.
Speaker 0:Persistence, adherence Are they staying on their meds on a daily and hourly basis. Right, this, you know. Over 50% of the patients only 50% take them as prescribed. We know that data right. And it can cost the healthcare system over $300 billion in the US a year. We've all seen that statistic, right, you know, for non-adherence. So you know it's avoidable. That's an avoidable expense that we, you know, we see at Medisafe and that's according to the WHO.
Speaker 0:If people just keep adherent to their medications, those impacts that come later down the road for not taking their medications can be sizable right. And the other challenge is on average, brands lose 80% of their patients in those first six months of therapy if they don't have effective support interventions, especially for certain medications. And this comes from Capgemini, there's a report on that and I'll link to that in the show notes. So when you think, every additional refill equates to meaningful revenue retention margins for the pharmacist, but also, we hope and we trust, better impacts for patients because we know they're refilling their meds, they're taking them on time and they're engaging and adhering and being persisting on the medications, the way they're all designed. This is why you're going to see a much higher increase on patient support, digital engagement programs. They really are going to start being reviewed as revenue preservation engines, really as a strategic competency.
Speaker 0:We're already seeing it now. I can attest to that digital transformation. It's often always focused on, like simplifying the CRM model, optimizing, you know, the sales team field force engagement, which is still there. But now pharma is going to be involving we already see it their digital proficiency into true patient-centric ecosystems. Right, and you know the challenge here for pharma is you can't.
Speaker 0:I think gone are the days and we've seen this across the board where you can simply put one app out there for your single brand and trust that patients taking five other medications which is, on average, what we see at Medisafe are actually going to integrate with that one brand, when they also have to manage five other medications that aren't referenced in that specific brand app, right. So let me download it. Nice to have it on their phone. If they have any reference for this new medication they're on, but they're not going to engage on a regular basis and message with you on a as-needed basis in a way where they're taking six other medications and they're on a single platform. That's managing all that, right. So you know, when you have personalized educational modules, they got tailored to the diagnosis, the diagnosis stage? Are they onboarding? Are they on a deep titration? Week two hey, you need to take two doses of this med now, not one right and then integrated co-pay support as well. That's going to be primarily a huge value now going forward for pharma teams.
Speaker 0:You know, with Medisave we've got more than 13 million people installs of the app. You know we're in 157 countries and territories and you know 27 language, so that's going to matter as well. You speak to people the way digital platforms can do it in ROI strong basis and in the way that they want to be contacted to, at the right time and using the right method. And you know, with our platform, we're seeing anywhere from a 20 to 30 percent adherence for certain programs we're doing at Pharma Partners and that's active users that we have on the medication and they may be enrolling in pharma programs as well. And when you embed digital tools like that into the therapy journey, it's a natural part of people's day, especially, like I said, on our platform.
Speaker 0:People are engaging at least once a day seven out of 10 people who come on a on a monthly basis to Medisafe right. So you're shaping their experience, their support. You can send them surveys. How are you doing on your meds. And the best thing about Medisafe is the patients use it in an anonymous fashion if they like. If they want, they could set up an account. We encourage that so that they can. You know, if they lose their phone or they buy a new phone, their account can be transferred over with all their data. Otherwise they lose it, but they have the option to stay anonymous as well. So we're getting a lot of that data in that.
Speaker 0:We know, not only in a specific medication but also competitor medications as well, if they're switching over. We're going to be able to address when people switch over when is their most likelihood on time and a trend that we see if they're going to switch to a competing medication and you can imagine a scenario where messaging can be sent ahead of that switch to patients when, for example, their copay balance is going to a certain level or whatever it is to keep them on brand and to increase that brand loyalty and a supported patient feels really confident and can be proactive with the brand and you can anticipate those challenges ahead of time and message patients. Hey, I was just about to reach out to you because I heard blah, blah, blah and in certain digital platforms like Medisafe, instead of having the support team constantly reaching out, you can actually have bi-directional support. So on our platform they can hey, now I need to talk to a nurse or my support team tap I have an issue, or hey, I just ran out or I see something's going on. That bi-directional communication, which doesn't exist necessarily with other solutions, is key and we see it definitely have an impact on a lack of abandonment on scripts. So, ultimately, that patient experience is really becoming a battleground and you know, digital loyalty infrastructure is really what we would call a key moat around that market share. So, as we see, pharma companies keep an eye out for them, preparing to really support digital solutions.
Speaker 0:With this MFN status, again, there's a September 29 deadline that's supposed to happen. That may obviously get extended through whether it's legal things, also through other delays. I think part of what we see with the tariffs. As long as countries were engaging and trying to work with solutions, some deadlines could be overlooked as things were progressing with certain pharma companies and we're already seeing some pharma companies agreeing to more investment. In the United States We've got a $50 billion investment by one company, including a new production plant in the Virginia area. We've got sizable price increases that we're seeing on the GLP-1s happening in Europe. So you are seeing some fluctuations in the market already as a result of what the White House has put out with their executive orders.
Speaker 0:So you know we see pharma companies, we see it here. I can tell you that they're now investing in solutions that really secure that patient loyalty and, you know, reinforce persistence and adherence and you know you're making those experiences, especially if you're getting on a new rare medication. Try to get that onboarding as comfortable as possible and be there as a support system, whether digitally or, you know, with a nurse and support team to have a top notch with the patients there. And the other point there is you know you're with a patient support team. You may be supporting 20% of the whole patient population there and the 80% of the population you want to make sure they're doing okay too. So the regular check-ins can be helpful as well with digital solutions, very ROI compatible and it can enhance ROI because you're still touching base with the remainder of the population that may not be as acutely talking with their support team. The way we say, the top 20% are right.
Speaker 0:So when you look at that environment of tighter reimbursement as well, because reimbursement rates are going to be tied to patient efficacy, which they always are and they are now. But when that loyalty is even more of a, when the patient length of on and at medication is being increased, because one of the variables is loyalty and they're staying on the medication longer, therefore the efficacy can be there as well, so is that environment on that reimbursement based on that is going to be even more powerful going forward than it is now. Consider the digital solutions like Medisafe and others, with support teams that are protecting brand market share and relevance. That's for sure, and really we're seeing it now. That's for sure, and really we're seeing it now. Now's the time for Palmer really re-imagining what that brand value means after the first script and launch and really keeping patients on longer and how they do that in effective ways. It's student feedback. If you like the podcast, please like and subscribe. Thanks so much for coming in today. Have a great day, everyone. Bye.
