Generic Competition Assessment Among Payers Using PV Scope®

Abstract

Facing imminent generic competition for their branded respiratory product, a pharmaceutical company engaged RG+A to help them understand the complex payer stakeholder landscape and to provide guidance on key strategies to strengthen the brand’s position with payers at present and following the generic launch. RG+A used our PV Scope® approach to iteratively engage a diverse group of payers in online, telephone, and bulletin board interviews. RG+A was able to provide the client with specific guidance on key levers that would be important to payers as well as insight on a major threat from a branded product that might thwart optimal market access if not challenged.

Background

RG+A’s client, a major pharmaceutical company with a branded respiratory product, was looking ahead to the imminent loss of exclusivity for a major competitor and the resulting generic competition that would then enter the marketplace. In order to minimize that competitive threat, the client sought to understand how to strengthen the position of their branded product among payers, and to develop contracting strategies that would anticipate and combat obstacles to preferred market access levels, ultimately leading to optimal brand access for their product.

Methodology

To address the client’s objectives, RG+A employed our proprietary PV Scope methodology, a fast-turn-around, iterative approach that includes telephone in-depth interviews, bulletin board discussions, and a Wisdom of Crowds exercise. RG+A engaged 20 medical and pharmacy directors from national, state, and regional managed care organizations, integrated delivery networks, and pharmacy benefits managers to participate in the PV Scope exercise.

Key Challenges

  1. Critical market access decisions were shared among multiple stakeholders
  2. Any market access strategy would need to accommodate highly dynamic market conditions
  3. With limited time and resources, the research would need to estimate the impact of multiple strategies

How the Design Addressed the Challenges

  1. Leveraging RG+A’s Health Payer Council, RG+A was able to recruit stakeholders from a diverse population of payer organizations and with multiple lines of business
  2. The iterative nature of PV Scope allowed for testing of various scenarios, flexibility in the direction of discussion, and co-creation on the part of participants
  3. The Wisdom of Crowds exercise permitted a higher degree of estimating specificity with a smaller sample size

RESULTS

The research confirmed that the client’s branded product already enjoyed a strong coverage position as a result of previous contracting efforts. The findings underscored that pricing pressure would be increased by the introduction of generics, highlighting the importance of discounting and rebating. Successfully acquiring preferred status for a branded product under those market conditions would need to include evidence of strong utilization and a commitment to solid contracting approaches. The findings also highlighted one key branded competitor with superior market share, and found that the branded product with the greatest market share at the time of launch would prevail among payers.

GUIDANCE

RG+A recommended the commencement of contract negotiations at the earliest opportunity in order to have these contracts in place and the strongest possible position for their brand at the time of generic introduction to the market. RG+A also recommended that our client’s brand focus on gaining market share over that key competitor identified in the research to further strengthen the client’s position at the time of generic launch. Our guidance for the most favorable position for the client’s brand was to “win” on contracting terms and “tie” on market share against the branded competitor. We advised a further phase of research that would include simulated contract negotiations to further strengthen the client’s position heading to the negotiating table.

ACTION

The client is currently working on integrating the results of RG+A research as well as our recommendations into their overall contracting strategy for this brand.