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ACA Impacts on Rx Marketing for Disabled Americans: Fee-for-Value and Patient Lifestyle Autonomy

Health care coverage was expanded automatically to 32 million Americans in March 2010 when President Barack Obama signed into law the Patient Portability and Affordable Care Act (ACA). President Obama stated, “My job is to set forward a vision – point people in the right direction.” Since the ACA eliminated pre-existing conditions, developmentally, intellectually and physically disabled patients become a separate target audience for pharmaceutical marketers currently faced with a new direction. The ACA impacts prescription marketing for the disabled both narrowly and broadly through fee-for-value and patient lifestyle autonomy, respectively, setting forth opportunities for pharmaceutical marketers to grow innovative business.

DiPersio-Julyartwork1Narrow Impact: Fee-for-Value
Overall value moves to the forefront of ACA’s goal to deliver more effective care at a lower cost to the disabled population while the platform of efficacy and safety shifts to the background. Pharmaceutical marketers engage in positioning and messaging to the influencers and stakeholders of the disabled, including family, friends, physicians, others who have disabilities and community groups. They market their products based on both clinical and economic outcomes. Expressing outcomes through emotional drivers, such as quality of life, evokes a deeper feeling among medical staff and patients. At the Mayo Clinic and Dartmouth Hitchcock Medical Center, shared decision making centers attract doctors and health coaches to assist the disabled in weighing options and making informed decisions about elective procedures. Due to some disabled patient mobility issues, marketing teams are gravitating toward business-to-business strategies instead of relying on frequent visits. Similarly, marketing channels include an integrated approach that reaches more remote locations of the target audience.

DiPersio-Julyartwork2Broad Impact: Patient & Lifestyle Autonomy
Many disabled have numerous, multi-faceted health problems and require more and different types of prescriptions with pharmaceutical marketers focusing on the promotion of patient and lifestyle autonomy. The statistics are overwhelming. On average, the disabled need 40% more prescriptions. They spend 50% more money on prescriptions drugs. Also, they are three times more likely to have high total drug spending. The ACA extends certain prescription drug coverage for Medicaid recipients. Coverage of anti-seizure and anti-spasm medications is also mandated under the health reform law. Thirty percent of disabled Americans confront challenges in travelling to pharmacies because they either live in rural areas or have disabilities which hinder their mobility. Under ACA, physicians can prescribe a variety of medically beneficial drugs without restrictions on how these medications are delivered to patients in a timely manner and without any major inconvenience to the disabled or their caregivers.

ACA is changing the lifestyle of disabled Americans and prescription marketing is geared toward their new living standards. Our country now has an educational system which is much more centered on preparing all students, regardless of any type of disability, for a university degree and/or a career. Under ACA, federal contractors must meet a quota for employing the disabled which creates jobs for this target audience. Opportunity Works provides community and center-based employment services and support to individuals allowing for more independent lifestyles including salaries. This agency allows for vocational assessment, career exploration, on-the-job training, placement, and supervision while teaching a variety of skills.

With steady employment, disabled Americans are afforded the opportunity to earn money to pay for their prescription benefits with private health carriers. They have a choice of carrying public or private coverage. Many special needs attorneys believe that the vast majority of Special Needs Trusts (SNT) patients will select private health insurance over Medicaid. The families of the disabled who are covered under the SNT are required to repay their benefits upon death which produces an excessive financial burden. Pharmaceutical marketers develop strategies now that aim its attention at a gainfully employed disabled population being assimilated into the general public as equal citizens living with dignity and garnering respect.

In summary, Harvard Professor Philip Kotler, author of the classic 1967 textbook “Marketing Management” developed the concept that marketing is the exchange of value between two parties. He maintains that marketing is the art of creating genuine customer value and helping customers become better off. Without a doubt, the ACA provides unparalleled opportunities for pharmaceutical manufacturers to market prescriptions to a large disabled population with narrow and broad ACA impacts of fee-for-service and patient lifestyle autonomy. Pharmaceutical companies change their thinking about beliefs and basic assumptions, beginning with identifying the disabled as a new target audience and understanding their needs, with the desire to increase business.

Linda J. DiPersio
Freelance Professional Writer
Linda J. DiPersio, MSM, MSHC, is a freelance professional writer and narrator/producer of an oral history video series for the Public Health Museum (estimated completion date June 2016). She earned a Master’s in Health Communication from Boston University and a Master’s in Management from Lesley University. Linda DiPersio has been published in the Journal of Communication in Healthcare. She is a member of the American Public Health Association and Massachusetts Public Health Association.
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