MMAFrom Concept to Market Reality:

1
MMAFrom Concept to Market Reality
Treating Patients in the New Part D Environment
March 6, 2006
2
Agenda
1
Key Issues
2
Physician Knowledge of Part D
3
Impact of Part D on Prescribing
4
Patient Challenges Assistance from Pharma
5
Challenges for Pharmaceutical Marketers
3
Key Issues

• What do Physicians Really KnowWhat Don't They
  Knowand What Do They Need to KnowAbout Medicare
  Part D?
• The First WeeksHow Is Part D Influencing
  Prescribing?
• What Do Physicians Perceive As Their Role With
  Patients, and How Can Pharma Help?

4
Physician Knowledge of Medicare Part D
5
Moderate General Knowledge of Part D
Mean Rating
Total Physicians
3.80
Rheums
4.24
PCPs
3.94
Psychs
3.87
Endos
3.40
Ob/Gyns
3.26
Cards
3.14
1
2
3
4
5
6
7
Not at All Knowledgeable
Extremely Knowledgeable
Source The Impact of MMA on Physicians (wave 2)
2006, GfK Market Measures
6
Limited Knowledge of Part D Formulary Placement
Mean Rating
2.68
Total Physicians
Psychs
2.96
EF
Rheums
2.78
Endos
2.72
PCPs
2.72
Ob/Gyns
2.39
Cards
2.37
1
2
3
4
5
6
7
Not at All Knowledgeable
Extremely Knowledgeable
7
More Information Needed on Plan-Specific
Formularies
July 2005 (Wave 1)
February 2006 (Wave 2)
Plan-specific formularies of Medicare
Prescription Drug Plans
76
67
52
68
Impact on out-of-pocket expenses
Benefit structure of Medicare Advantage or Rx
Drug Plans
48
64
46

Appeals process
41
65
Patient eligibility information
20
44
Medicare Part D regions
6
2
Other
0
15
30
45
60
75
Percent of Physicians
Not included in 2005 study
8
Impact of Part D on Prescribing
9
Product Selection Moderately Impacted by Part D
Mean Rating
Total Physicians
3.99
PCPs
4.15
Psychs
3.98
Cards
3.61
Rheums
3.52
Endos
3.49
Ob/Gyns
3.39
1
2
3
4
5
6
7
Not At All Influenced
Greatly Influenced
10
In the Physicians Own Words
Ive had to figure out which medications are
coveredparticularly true with ACEs, statins,
PPIsand ARBs. GP/FP
11
Part D Status Influences Product Selection Half
of the Time
February 2006 (Wave 2)
July 2005 (Wave 1)
55
45
Total Physicians
PCPs
57
46
Psychs
51
41
Ob/Gyns
50
56
49
41
Cards
Rheums
42
40
Endos
40
45
0
15
30
45
60
75
Percent of Time Product Selection Influenced
12
Formulary Status More Influential for Part D vs.
Commercial Coverage
55
Part D Patients
Patients with Commercial Benefits
43
0
15
30
45
60
75
Percent of Time Product Selection Influenced
13
One-Fifth of Patients Prescriptions Change Due
to Part D
14
Patient and Pharmacist Requests Influence Product
Switches
No changes made
MD initiated conversations with patient leading
to change
Prompted by managed care
10
10
20
35
24
In response to patient request
Initiated by pharmacist calling MD
15
Movement Toward GenericsAway From Brands
25
Increased Significantly
6
66
Limited/Moderate Change
76
9
Decreased Significantly
18
0
20
40
60
80
Brand Name Agents
Generic Agents
16
Few Exceptions Filed Thus Far
Total Physicians
9
Psychs
12
Rheums
11
10
PCPs
Endos
9
4
Cards
Ob/Gyns
4
0
5
10
15
20
Proportion of Part D Prescriptions For Which
Exceptions Were Filed
17
Patient Challenges and Assistance from Pharma
18
Physicians Estimate More Than Half of Patients
Not Yet Enrolled
Patients Not Yet Enrolled
Enrolled or MD is Unaware
47
53
19
Key Challenges with Patients
20
In the Physicians Own Words
The first challenge is getting the
medicationmost of the plans dont carry all the
medicationsPatients have no idea, as well as the
doctors.
Cardiologist
21
Moderate Involvement in Aiding Patients
Understanding of Part D
Mean Rating
3.17
Total Physicians
Psychs
3.72
Rheums
3.57
3.30
PCPs
Cards
2.47
Endos
2.47
Ob/Gyns
2.28
1
2
3
4
5
6
7
Not at All Involved
Very Involved
22
Not My JobBut Im Involved Anyway
23
Physicians Offer General Advice and Clarify
Terminology
I help patients understand managed care
terminology (e.g., donut hole, co-pays,
deductibles)
61
I help patients decide whether to enroll
56
I help patients to select a Medicare Part D plan
27
I help patients decide between MA-PDs and stand
alone PDPs
22
0
10
20
30
40
50
60
70
Percent of Physicians
24
Some Interest in Receiving Updates/Information
From Pharma on Medicare Part D
69
Government
47
Medical Associations
Pharmaceutical Companies
37
31
MCOs/PBMs
22
Patients
13
Colleagues
3
Other
None/dont want information or updates
6
0
15
30
45
60
75
Percent of Physicians
25
Physicians Prefer Receiving Updates/Information
from Pharma Via Direct Mailings and Rep Visits
Direct mailing to my office
70
63
Pharmaceutical Sales Reps
50
Conferences
39
Websites
35
E-mail
24
Peer-reviewed articles
18
Web-conferences
5
Other
0
15
30
45
60
75
Percent of Physicians Who Have Interest in
Info/Updates From Pharma
26
Challenges for Pharmaceutical Marketers

• Assessing and tracking the impact of Part D on
  physicians treatment patterns and product
  selection for both Medicare and commercial lives
• Identifying and addressing unmet information and
  support needs that physicians have in the New
  Part D environment
• Educating physicians to better help their
  patients
• Organizing and communicating changes in brand
  formulary status to physicians

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Contact Information

• Larry Olson
• MMA Practice Area Director
• GfK Market Measures
• lolson_at_gfkmarketmeasures.com
• [phone]

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Thank You !