Q: How do you explain co-pay accumulator programs to people?
A: Here we are talking about a program that impacts patients who use a manufacturer- provided card to help cover their co-pay. Co-pay accumulator programs are not as familiar a concept as, say, prior authorization or step therapy.
Read MoreQ: What’s the best way to explain prior authorization?
A: It’s best understood in layman’s terms. If I ask a group of patients if they’ve had any issues with prior authorization, no one will raise their hand. But when I break it down and ask if anyone has had to prove to their health plan that they need a medication, heads start nodding. Hands shoot up.
Read MoreQ. “Non-medical switching” is an unfamiliar term to many. How do you explain it?
The term “non-medical switching” can be confusing, but everyone knows someone with a chronic health condition. So I frame it in those terms. I explain that the goal is to protect patients’ access to medications that keep them stable, that it’s senseless to take away a treatment that’s working. People seem to understand that intuitively
Read MoreQ. What’s the best way to define step therapy?
I have found people respond better to the term “fail first.” It’s more intuitive for patients. When they hear “fail first,” it clicks with them that they are being forced by their insurer to try a different medication and only get the one they were prescribed if the first “fails” to help.
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