How Customized Copay Analytics Help Brands Build Market Share

Est. reading time: 4 mins

Data analysis is the backbone to every strong copay program. Today, successful brands all use data to inform strategic decisions on their business rules, rebates, and price points. But every brand has different needs to achieve their unique goals, so it’s imperative that brands employ customized data strategies to ensure their patient access programs are optimizing effectively.  

Customized data strategies will look different depending on the brand. Tailoring data to your program could look like analyzing specific territory reporting, monitoring refill rates across the patient journey, or understanding coverage rates across payers.  Truveris’ expert analysts have pulled together 4 impactful ways that brands can leverage a customized data approach to build market share and drive improved patient access.   

1. Understand unique coverage rates through payer data analysis 

Brands have a unique relationship with each major PBM and payer, and it is critical for brands to successfully negotiate coverage status and formulary tiering. A brand can spend a lot of time ensuring that these payer relationships are optimized so that their patients can access the drug. But often, a brand cannot determine whether payers are honoring agreed upon coverage rates.  

Payer-level data allow brands to look at exactly how specific PBMs are processing brand claims, helping brands triangulate their coverage estimates versus payer realities. Through these data, brands can see if a specific payer has lower than expected coverage rates, and therefore identify opportunities to mitigate this coverage gap to drive more claims. For example, if a brand notices a gap in expected coverage at a specific PBM, they can work to drive education to the PBM partner about their missed opportunity in the form of rebates from covered claims.   

Analysis of payer data can also help determine copay fraud earlier. For example, payer level data could flag that a specific pharmacy is only using one BIN to process all of their claims, indicating either a procedural breakdown or potential fraud incident. By detecting fraud earlier, a brand can save significantly on their copay card spend.  

2. Segment your offerings through business rule optimization  

The logic and set of parameters behind the scenes that determine how patient benefit dollars are allocated to each prescription claim are known as business rules. Business rules are the crux of every copay program, and brands know that optimizing business rules can lead to significant brand growth. However, many brands are not sure how to take their business rules to the next level through segmentation. Through understanding specific patient profiles, brands can tailor business rules that cater to a specific segment.  

For example, a brand can run an analysis of covered versus uncovered patients. To reach more uncovered patients, the brand can take the approach of differentiating offers between cash and uncovered programs, which can help drive pharmacies to check for and utilize brand coverage for uncovered patients. Or a brand could run an analysis looking at their patient walkaway behavior by segment, and use the findings to inform new patient copay price points with decreased copay card spend. After implementing similar business rule strategies from Truveris, a client experienced a 125% increase in monthly claim volume over the 20 months after the changes were made, leading to about $2.5M in additional revenue in two years.   

3. Harness geographic and demographic-specific reporting  

Demographic patient reporting allows brands to understand the unique patient profiles of a specific drug. This can help a brand to optimize business rules and build offerings around specific patient segments. By segmenting patient claims data by geography or age, brands can make more informed decisions and better reach their target patient population.  

In addition to patient-centric demographic reporting, understanding data around geographic prescribing trends can also help a brand optimize their patient access strategy. Claims, coverage rates, and prescribing trends can often vary significantly depending on where in the country they occur. Many innovative brands are harnessing territory reporting to map out sales representative performance. By analyzing claims in specific zip codes and territories, the brand can determine compensation for their sales team. 

For example, one Truveris client used territory reporting to see which physicians had written the highest number of scripts, by territory. This was then used to understand which sales team members had the best performance during the year.  

4. Track refill rates over time 

Refill rates directly impact the success of a drug – it is common knowledge that a higher refill rate results in better outcomes for patients. But some brands struggle to get a realistic snapshot of how their refill rates are trending over time. 

Sophisticated copay programs enable brands to understand real numbers for adherence, accounting for reversal rate impacts. By building a refill rate dashboard, a copay program can track cohorts of patients over time to determine refill rates. This enables brands to better understand behaviors during the patient journey, enabling the brand team and partners to adjust business rules and deploy innovative, patient-focused strategies to drive adherence.  


As the pharma landscape and market becomes more complex, it’s critical to partner with a vendor who can serve all your data needs and customize your analytics approach. 

Truveris is a leading digital health company focused on delivering truth and clarity in pharmacy. Truveris’ proprietary technology, coupled with deep pharmacy expertise, helps to build a more efficient market that maximizes choice, accessibility, and prescription drug affordability. Our solutions provide the insight and knowledge to help people lead healthier and more productive lives.

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Contact our team today to see how Truveris’ technology and expertise could revolutionize your pharmacy benefits program.