What are some struggles that you’ve faced over the last few years with respect to getting a branded prescription?

Dr. James Katz: In our practice, it’s been about call-backs. We receive so many call-backs for medications when we prescribe branded products. Patients try to get the medications, and they’re not covered by insurance or they’re too expensive, so they come back to us for second choices and sometimes third choices. So, we don’t get the same medications we expect our patients to use.

Dr. Gregory J. Katz: Call-backs are a tremendous problem. Filling out prior authorizations, which you often have to do for medications that aren’t covered, is just a very time-consuming process. Often, we’ll fill out a prior authorization and sometimes it won’t get accepted. Then we’ll fill out another prior authorization and finally it gets accepted, but then the cost is just unacceptably high for the patient. There’s so much uncertainty. My patient will often ask me, ‘So, how much is this going to cost?’ And typically, I’ll just tell them, ‘I have no idea, because every plan is so different.’ And these are the frustrations that we’re going through.

Dr. Robert J. Noecker: I don’t want to spend my time with a patient talking about how much they paid the last time for their medication. I want to talk about their disease and see how they’re doing. But I find that, more and more, I’m hearing, ‘I paid this when I went to the pharmacy.’ I like to always think that I’m recommending the best drug when I prescribe something. Then I can say, ‘Okay, now I’ll give you the second-best drug, and I hope you don’t have a problem with it.’

Dr. James Katz: That’s right. We try to use the products that we think are best, and there is some loss of confidence when we switch over to another category for the patient.

Any other issues you face in prescribing branded medication? Any solutions you’ve tried to get around these issues?

Dr. Gregory J. Katz: We found co-pay cards useful. But they’re hard or almost impossible to use on Medicare or Medicaid patients. And even on the commercial patients, depending on what pharmacy they go to, if the pharmacist isn’t very familiar with the card or doesn’t want to deal with it, we get a lot of call-backs on that.

Dr. Robert J. Noecker: I really like the co-pay card programs, but for us, because of the way our state government is, a lot of our patients are Medicare patients, so they can’t use it.

Can you talk about the experiences you’re having in your practices with MyChoiceRx?

Dr. Gregory J. Katz: We have had no prior authorizations that we’ve needed to do. I’ve had no patients that have not been able to get the medicine through this program. We’ve had very limited call-backs. And when the patients ask, ‘How much is this going to cost?’ we know exactly how much it’s going to cost.

Dr. James Katz: I know my patients are going to pay no more than $60 for Durezol (Novartis) or Ilevro (Novartis), and those are the products I use. There’s a comfort for us in telling a patient that, and it’s quick. In our practice it’s about workflow, keeping it efficient, and moving on. (Figures 1 and 2).

Dr. Robert J. Noecker: It gives a bit of predictability.

Do you have any closing thoughts?

Dr. James Katz: I think patients see this as, we’re advocates for them, so it works out both ways. We are trying to deliver the correct medications, or the ones we believe in, to our patients at the best price we can. We’re doing it in an efficient manner for our patients.

The speakers were paid by Novartis Pharmaceuticals Corporation (NPC) to conduct this presentation.