BlinkRx Chief Executive Examines Direct-to-Patient Access Models
First-fill conversion rates for branded medications sit at 44 percent, while launch brands struggle to reach 28 percent. Geoff Chaiken, CEO at BlinkRx, examined direct-to-patient prescription access models in a guest post published on Drug Channels, pointing out that telemedicine, consumer rebates through cash discount cards, and cash-pay pharmacies each improve access in narrow ways without solving the underlying hurdles of prescription fulfillment and adherence.
In Plain English: The Clinical Takeaway
- First-fill conversion: This metric tracks the percentage of patients who actually pick up their newly prescribed medication at the pharmacy counter.
- Adherence: This refers to whether patients continue taking their prescribed medication regularly over the course of a year, which drops to just one-third for branded therapies.
- Prior authorization: This is a health plan requirement where a physician must obtain approval from an insurance provider before the drug is covered for the patient.
Evaluating Telemedicine and Cash Discount Cards in Prescription Access
Telemedicine platforms market directly to consumers and connect them with healthcare practitioners, but their reach remains limited outside of specific categories like weight loss, erectile dysfunction, and hair loss. Many direct telemedicine providers do not accept insurance and charge subscription fees on top of medication costs, consuming money patients could otherwise spend on treatment.
Consumer discount cards and price-comparison websites deliver manufacturer rebates at the pharmacy counter, sometimes making cash prices lower than insured copays. In 2017, Blink launched a program with Lilly that reduced cash prices for Lilly insulins by 50 percent, bringing the cost to approximately $250. Despite the medication’s lifesaving role and significant advertising, uptake remained limited. Patients make decisions in dollars rather than percentage discounts, and fulfillment drops steeply when out-of-pocket costs exceed approximately $70. The average out-of-pocket price across these programs sits at about $350.
The Limits of Cash-Pay Direct Pharmacies
Manufacturer-sponsored cash pharmacies let manufacturers offer prices directly to consumers and build direct patient relationships, providing an important access point for brands with limited insurance coverage. However, cash-only fulfillment carries distinct drawbacks for patients and manufacturers alike. Patients paying cash often pay more than their insurance copay and consequently discontinue therapy sooner. Without adjudicated insurance claims, manufacturers lose a vital channel for demonstrating demand to insurers, which hinders efforts to secure broader coverage and reduce patient costs over time.
Drug Channels noted that a discount alone cannot carry a patient through the access journey. Cash pharmacies can bridge a coverage gap temporarily, but they fail to provide a comprehensive, durable solution across commercial insurance, government programs, and cash-pay options. Manufacturers need a unified operating system that handles affordability, insurance coverage, and pharmacy fulfillment from the first fill through every refill.
References
- Drug Channels. “BlinkRx Insights: Clarifying the Mystery around ‘DTP’.” Guest post by Geoff Chaiken.
- Retailwit.com. BlinkRx Insights: Clarifying the Mystery around ‘DTP’.
