Why This Women’s Health Brand Was in Search of a Commercial Partner

After FDA approval, this women’s health brand launched with an indication to treat hypoactive sexual desire disorder (HSDD) in women. Before engaging Phil, the brand implemented a commercial launch strategy consisting of a two- month bridge program, a network of regional specialty pharmacies to facilitate access, and an integration with a telemedicine platform to allow women to access care easily. Despite a carefully developed commercial plan that also coincided with significant formulary placement among national and local payers, the brand’s growth stalled because their specialty pharmacy partner was ill-equipped to address commonly experienced channel challenges resulting in:

1. Low Access Program Enrollment - 2% of Patients The specialty pharmacy utilized automated phone calls to engage patients. This antiquated approach paired with a lengthy enrollment process deterred most patients from enrolling. One year after launch, enrollment hovered in the low single digits resulting in limited prior authorization success.

2. Poor Conversion of Market Access - 25% of Eligible Rx While many patients took advantage of the two month bridge program, few received payer coverage despite the brand having 85% formulary placement. The combination of a poor user experience, prior authorization (PA) submission bottlenecks, and limited pharmacy network coverage (60%) resulted in the low conversion of market access to covered dispenses.

3. Low Refill Adherence - 1.5 refills Per Patient With limited means to convert formulary placement to coverage, the specialty pharmacy network relied heavily on manufacturer financial support to get patients on therapy - adversely impacting the brand’s financial outcomes. As patients faced higher out-of-pocket spend after the expiration of the bridge, the brand suffered high drop off.

These factors threatened the brand’s financial future and prompted the commercial team to re-evaluate its strategy and channel partner.

Partnering with PhilRx for a Strategic Access Partner

Facing a genuinely existential threat if they did not improve performance, the brand needed a strategic partner that could support a turnaround. They needed a platform to help them convert formulary placement to covered dispenses to improve their patient and financial outcomes. With limited visibility into the drug channel with a specialty pharmacy partner, they also needed more data to respond to payer PA behavior to be able to differentiate dispense programs to allow them to balance supporting easy access therapy with sound financial stewardship.

After an extensive search, the team ultimately chose to partner with Phil because of our proven results, the ease of integration with partners like their telemedicine provider, and Phil’s willingness to make adjustments to configure the PhilRx platform to the brand’s needs as their business evolved.

Partnership Goals:

• Implement a Seamless Patient & HCP Experience Create frictionless prescribing and PA processes for healthcare providers (HCPs) and ensure patients can effortlessly access and adhere to therapy.

• Convert Market Access to Covered Dispenses Streamline the process for approving coverage and provide differentiated dispense programs based on payer behavior while routing all prescriptions to the appropriate pharmacies based on each individual’s insurance.

• Equip the Field Team Ensure the field team has the right tools and data to leverage their relationships with HCPs to close gaps by assisting those who experience bottlenecks with the PA submission process.

Elevating The Brand’s Commercial Strategy

To resuscitate the program, Phil partnered with the brand’s commercial team to implement a customized solution in six weeks. We developed a unique access workflow that dispensed their bridge prescriptions when appropriate while simultaneously pursuing PAs. Additionally, Phil integrated directly with their 3rd party telemedicine partner.

The Phil solution included:

1. Seamless Digital Enrollment: After receiving a prescription, women received a text to enroll on their smartphone (no app required) to receive their prescription.

2. “1-click” PA Submissions: Our platform, layered on top of CoverMyMeds utilized software to extract information from the eRx to populate PA submission forms to make them easy to submit.

3. Optimized Pharmacy Routing: After receiving an Rx, demographic, and benefit information, the prescription was routed to the appropriate pharmacy with plan contract coverage to ensure access.

4. Differentiated Dispense Programs: By utilizing data to inform business rules, patients received a differentiated access experience based on their insurance plan’s PA behavior.

5. Ongoing Adherence Support: Patients received ongoing digital and live support to ensure they could safely adhere to therapy.

6. Data & Actionable Insights: The platform provided access to over 120 real time data points and a field enablement dashboard.

Driving Commercial Success with PhilRx

Data-Driven Program Optimizations 

When Phil partners with life sciences manufacturers, we take a proactive approach to driving program and brand success. Our Business Operations team evaluates ongoing program data to make recommendations that can improve outcomes. As the program evolved, our team uncovered that the brand had an opportunity to improve copay program design to lower out-of-pocket costs for covered patients on refills, thereby enhancing adherence and gross-to-net outcomes.

Recommendation: Reduce copay for covered patients from $20 to $0 on the 3rd fill and after to prevent patient drop-off at the 3rd fill.