May 9, 2011 
One of the key questions from PBMs, pharmacies, specialty pharmacies, and payers is…
How can we drive utilization of a preferred channel (retail, mail order, specialty)?
I’ve worked on 15+ different “retail-to-mail” type programs (or even just 30-day to 90-day). They typically follow a pretty standard profile:
- Identify who to target
- Plan design (does the member save? the payer?)
- Maintenance drugs
- Categories (is titration an issue?)
- Score individuals for prioritized outreach
- Likelihood to convert (drug, prior experience, costs)
- Create personalized messaging
- What’s In It For Me (WIIFM) – cost, convenience
- Create business rules
- What’s the best channel?
- What’s the best time to call or e-mail?
- Engage people and quickly transfer them to an agent who can answer their questions
- How do I get started?
- How much will I save?
- Why should I do this?
- Who are you?
- Make the process easy…call or fax their provider and get a new prescription for the new pharmacy
- Implement a process of continuous improvement
- What works?
- What could be better?
- Are their differences within certain sub-segments?
- How can I test and validate my assumptions?
At the end of the day, this approach can also be used for formulary support and many other programs. The important things are:
- Engage the consumer in a dialogue about their options
- Be clear about the value of change
- Make the process easy
- Answer their questions
Enabling Healthy Decisions 
I guess I left off the obvious…make it mandatory.
The other less obvious is to leverage the “choice architecture” concept which you see in Select Home Delivery (Express Scripts) or the Maintenance Choice offering (CVS Caremark).
Plan design always trumps communications for success, but if not managed correctly, it can drive disruption up and satisfaction down.