Market Access Pull-Through Marketing: Targeting After a Formulary Win
What market access pull-through means, how brands turn formulary wins into prescriptions, how to target HCPs by plan coverage, and how to measure it.
The short answer
Market access pull-through is the work of turning a payer or formulary win into actual prescriptions. Brands identify HCPs whose patients are covered by the newly favorable plans, tell them about the improved coverage with approved messages, help their practice staff with any remaining requirements, and measure whether prescribing rises among patients in those plans.
A formulary win does not sell a drug. Many HCPs do not track coverage plan by plan, and practice staff may still expect prior authorization hurdles that no longer apply. Pull-through closes that gap.
Why pull-through is needed
- HCPs prescribe from habit and from what they believe is covered.
- Coverage changes plan by plan, region by region.
- Practice staff remember past denials.
- Patients may not know their costs have dropped.
Without pull-through, the brand pays for access through rebates without getting the volume.
Step 1: Find the right HCPs
Use claims to estimate each HCP's patient mix by plan. Prioritize:
- HCPs with many patients in the newly favorable plans.
- HCPs who see eligible patients but prescribe competitors.
- Regions where the coverage change is concentrated.
This creates a pull-through target list, often different from the brand's standard tiering.
Step 2: Say the right thing
Coverage messages must be accurate and current. Typical content:
- Which plan and which formulary tier.
- Whether prior authorization or step therapy still applies.
- Effective dates.
- Where staff can get support.
Accuracy matters. An out-of-date coverage claim creates compliance risk and frustrates offices. Build a process to update or stop messages when coverage changes.
Step 3: Choose channels
| Channel | Role |
|---|---|
| Field and key account managers | Explain changes to high-priority practices |
| Email to HCPs and practice staff | Specific, plan-level updates |
| NPI-matched programmatic | Reminder of coverage to targeted HCPs |
| Point of care and EHR | Coverage message near prescribing, where allowed |
| Patient channels | Savings and coverage awareness for covered patients |
Practice staff are a key audience. They handle benefits checks and prior authorization. See HCP vs. HCO for organization-level work.
Step 4: Measure
Compare prescribing in the affected plans before and after the change. To separate pull-through from the coverage change itself, compare:
- HCPs who received pull-through messaging with similar HCPs who did not.
- Affected plans with similar unaffected plans.
The measurement framework explains control-group designs for Rx outcomes.
Timing
Pull-through works best quickly after a coverage change takes effect, while it is news. Plan creative and lists before the effective date so messages can go live on day one. Keep a light reminder running for several months.
Common mistakes
- Messaging coverage to every HCP, not those whose patients benefit.
- Outdated coverage claims left running.
- Ignoring practice staff.
- Crediting all post-change growth to pull-through messaging.
Practical takeaway
For your next coverage change, build the plan-weighted HCP list before the effective date and hold out a small random share of it from messaging. Comparing the two groups tells you what pull-through added beyond the coverage win.
Frequently asked questions
What does pull-through mean in pharma?
Converting improved coverage into prescriptions by making sure HCPs and patients in the covered plans know about it and can use it.
How do you target pull-through?
By identifying HCPs with a high share of patients in the plans that improved coverage, usually from claims data, and prioritizing them for messaging.
How is pull-through measured?
By comparing prescribing in the affected plans before and after the change, and against similar plans or HCPs without the change.
Sources
External guidance and platform documentation change. Links were current at publication; check them again before relying on them for a decision.
Editorial note. Analysis and frameworks are the author's own and do not represent Acxiom or any current or former employer, client, or named platform. Examples labeled hypothetical or illustrative are not results from real campaigns. Nothing here is legal, regulatory, or medical advice.
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