With PBMs gaining power, pharma and ad agencies zero in on payer marketing

Doctor in hospital with health insurance related icons in modern graphic interface showing symbol of healthcare person, money saving, medical treatment and benefits
Pharma companies and healthcare ad agencies are trying to figure out how to better market to payers as they become more important in drug prescribing procedures. (Getty Images/nanostockk)

As the balance of prescribing power shifts toward payers, so too is pharma marketing. Both healthcare agencies and pharma companies are honing their payer-marketing strategies, driven by the gatekeepers' larger role in drug decision-making.

Also part of the push? Payer demands for proof-of-outcomes results and stronger evidence to back up reimbursement decisions.

“In the past few years, the market access conversation has become critical, and we’ve seen our work increase because of it,” said Doug Wynn, head of market access strategy for Publicis Health’s Maxcess Managed Markets. “The type of work has deepened and become much more strategic around outcomes, health analytics, predictive modeling and hyper-targeted messages.”

Free Daily Newsletter

Like this story? Subscribe to FiercePharma!

Biopharma is a fast-growing world where big ideas come along daily. Our subscribers rely on FiercePharma as their must-read source for the latest news, analysis and data on drugs and the companies that make them. Sign up today to get pharma news and updates delivered to your inbox and read on the go.

Pharma companies need to reach payers with better messaging and communications that go beyond the usual brand attributes and clinical data, Wynn said. Healthcare agencies, meanwhile, are doing their part by building out payer marketing practices, adding data and analytics talent and pushing the importance of payer marketing with clients.

“Agencies are trying to get out in front of an inevitable shift, as the locus of control over prescribing decisions migrates upstream from patients and physicians to payers,” said Matthew Arnold, DRG Digital principal analyst.

RELATED: Advice for pharma in payer marketing? Ramp up digital, study finds

That power shift is already well underway. Only 16% of physicians always prescribe their first-choice drug these days, while the other 84% usually or always follow formulary guidelines, according to the DRG Digital/Manhattan Research Taking the Pulse survey for 2017.

Publicis Health is one of the agencies making acquisitions to bulk up their market access practices, most recently with the purchase of Payer Sciences last month.

Wynn, formerly a pharmacy director at United Healthcare, remembers being frustrated back then by pharma companies that focused only on pushing the brand.

“They would tell a clinical story without understanding what were my decision drivers as a health plan decisionmaker, what was keeping me up at night and why my CEO was slapping me on the hand every other day,” he said. That has evolved, he added, to today when “the strongest brands that come to market now have to have an above-brand dialogue, or they’ll lose. It’s not just about pushing the brand, it’s about the relationship.”

He admitted some “diehard” pharma players still think healthcare providers are the only people they need to win over in drug marketing. But most have come around to the fact that the influencers and decision-makers in prescription drug payment—especially CMS, the largest payer in the country—are just as important.

RELATED: Payers say they'll cover pharma's beyond-the-pill offerings. They just want proof first

DRG offers some advice for pharma based on its market-access research. They suggest adding beyond-the-pill value for payers, for instance. DRG found 74% of all pharmacy and therapeutics committee members at payers are interested in working with pharma on patient-centered digital tools to reduce readmissions, while another 66% want digital “pill-plus” tools to improve adherence.

The research group also suggested pharma reps add interactive elements to payer presentations for better engagement, using omnichannel strategies so busy payers can dial into information at their convenience.

“Payers and organized customers have taken their places alongside healthcare professionals and consumers in the pantheon of pharma’s key stakeholders," Arnold wrote in a blog post. "That’s a pretty monumental shift, comparable to the introduction of consumer advertising 20 years ago."