Strategies to Counteract DTC Advertising

How can employers and plan sponsors manage the costly effects of DTC advertising? PBMI conference speakers agreed that patient education and generic dispensing help to counteract utilization changes triggered by DTC advertising.

Providing patients with information on therapeutic categories with heavily advertised drugs can help counteract DTC advertising, said Marilyn Gordon, assistant vice president of formulary services for National Prescription Administrators. Arming patients with information about disease states encourages communication between the patient and the physician. In addition, providing the patient with goals and information about therapies, a list of preferred products, and cost sharing |information many times will foster an open discussion between the patient and the physician as well.

"It is easier to get the physician to write the preferred prescription the first time. It is more difficult to switch to a preferred product later," Gordon said.

Counter detailing strategies can take the form of newsletters, copayment coupons for preferred medications or incentives to try behavior modification where applicable (such as a coupon for a waiver of the Weight Watcher's program initiation fee, or a coupon to try an over the counter remedy such as Pepto-Bismol®). The only limit to successful counter detailing is the employer's budget and imagination. Successful patient education can result in a positive shift to a lower cost, preferred product while keeping utilization constant. The key is to develop patient-focused programs that address confidentiality, funding and sponsor acceptance.

Merck-Medco's Stettin stressed that physician education is more important than ever to help drive increases in generic utilization. Employers might want to profile their top prescribers to communicate with them about:

• Generic alternatives for drugs about to go off patent,
• New drugs entering the marketplace, and
• Value of mail-service pharmacy for their patients on maintenance medications.

Stettin emphasized that mandatory mail service is a successful strategy, driving costs down from $16.70 to $15.51 per member per month (PMPM) in one Merck case study.