Pfizers eCard and adherence in emerging markets
How Pfizers medication loyalty card helps keep long-term therapy on track
As pharmaceutical companies increasingly turn their attention to emerging markets, they must find ways of addressing fundamental issues, such as affordability and patient access to medicines, if they are to reap the volume gains in these territories.
These volume gains are, after all, the only thing that will compensate for more flexible pricing arrangements geared to local economic conditions.
Part of that picture is drug concordance, an issue whose importance to a cost-conscious healthcare sector is amplified in markets where a substantially larger number of patients may be paying for drugs out of their own pockets.
The challenge is to make these drugs affordable to the patient in the first place, and then make sure the benefitsnot to mention the ensuing revenue streamsare not squandered or disrupted by poor adherence to therapy.
An interactive relationship with patients
With many drug concordance or adherence strategies, new technology is providing the platform for a more interactive relationship with patients that can help to keep long-term therapy on track. (For more on technology and adherence, see The role of new technologies in enhancing compliance.)
Pfizers eCard, now in use across a number of emerging markets, functions along similar lines to a retail loyalty card.
The customer gets discounts as a reward for, or inducement to, loyalty to a particular supplier.
In this context, discounts are awarded for adherence to Pfizer medicines.
The supplier gathers data through the card to track consumption patterns.
As befits the more regulated prescription drug market, though, there is still an intermediary between the eCard supplier and patient.
The card is available free of charge to patients, but on the discretion of the prescribing doctor and only at participating pharmacies. (For more on pharmacies and compliance, see The pharmacist's role in patient adherence.)
To deter abuse, there is also a monthly ceiling on the number of product units available under the scheme.
Emerging markets
The eCard was originally launched in the Philippines in 2004, and has since rolled out into Malaysia, Indonesia, Hong Kong, Mexico, and Brazil. A launch in Russia is also under way.
According to Pfizer spokesperson Samantha Cummis, Pfizers emerging markets business unit is reviewing progress to date and whether conditions are favorable to take the eCard into other markets.
At the moment, there are certain markets indicative of the viability of the program, Cummis notes.
While the initiative is not a perfect fit for every emerging market, Pfizer is taking a look at all of these markets and will modify the program where necessary to align with local regulations.
Patients using the card get a committed discount on the relevant Pfizer medicines in partner drugstores, with the level of discount varying from market to market, Cummis explains.
The program covers treatments for chronic diseases such as high cholesterol, hypertension, and central nervous disorders, including the leading statin brand Lipitor (atorvastatin).
Privacy issues
In the Philippines last year, the eCard, known locally as the Pfizer Sulit Card, was integrated into the Government Service Insurance System E-Card Plus for government workers and pensioners.
According to the Philippine Information Agency, discounts of 30% to 60% were available on 22 Pfizer drugs, including Lipitor, the antihypertensive Norvasc (amlodipine besylate), and the arthritis treatment Celebrex (celecoxib).
While the discounts in themselves are an inducement to better adherence, the eCard program also includes educational materials to help patients understand and manage their conditions, while also recognizing the importance of completing therapy, Cummis says.
While so far no formal study has been conducted to assess the programs impact on clinical outcomes, in general adherence among patients using the card has improved considerably, she comments.
The usage data transmitted through the card allow Pfizer to reimburse partner pharmacies for the discounts on the relevant medicines while tracking adherence.
For some, this level of data access has raised the specter of direct marketing to patients.
Cummis acknowledges that privacy issues were among the considerations determining where the eCard would go next.
But she says Pfizer was inferring adherence patterns from quantities of drugs purchased over time.
The company was not seeking out data on a per-patient level, nor was it trying to identify individual patients, Cummis adds.
Rather, Pfizer considered patients as a group to see if drug compliance was improving: We dont know who each patient is.
The added value to Pfizer, Cummis says, is that people are taking their medication.
For more on emerging markets, see Cracking the Chinese pharma market, Breaking into the Brazilian pharma market, Reassessing Russia's pharma market, and The Middle East: A pharma market in the making.