Mapping the HCP and patient funnel stage by stage

# Mapping the HCP and patient funnelfunnelThe customer journey from awareness to purchase, typically Awareness, Interest, Consideration, Decision, Action, with prospects narrowing at each stage.View full definition → stage by stage

A rep leaves a sample of a new GLP-1 drug with an endocrinologist on Monday. Six weeks later, exactly one prescription shows up in pharmacy claims data. That six-week gap, and the 90% of samples that never convert, is the entire pharma marketing funnelmarketing funnelFunnel analysis tracks how users move through a sequence of steps toward a goal, revealing where they drop off and which stages need improvement.View full definition → compressed into one number. Understanding why some drugs turn samples into scripts in days and others take months is what this lesson is about.

Pharma marketing runs two funnels at once, HCP (healthcare provider) and patient, that must sync for a launch to work. Miss the handoff and you get a great awareness campaign with no prescriptions to show for it.

Why pharma has two funnels, not one

In most consumer categories, the buyer and the user are the same person. In pharma, the HCP prescribes, the patient (or payer) pays and takes the drug, and often a third party, the Pharmacy Benefit Manager (PBM), decides whether insurance covers it at all.

That means marketing has to run two parallel journeys:

• HCP funnel: awareness → detailing (rep visits) → sample request → trial prescription → repeat prescription.
• Patient funnel: diagnosis/awareness → prescription received → co-pay card activation → first fill → refill (adherence).

They intersect at the point of prescription, but each has its own drop-off points and its own metrics.

Stage 1: HCP awareness and consideration

This is measured with reachreachThe number of unique people exposed to your message in a given period. Unlike impressions, reach counts each person once, no matter how often they see it.View full definition → and frequency metrics familiar from any B2B funnelfunnelThe customer journey from awareness to purchase, typically Awareness, Interest, Consideration, Decision, Action, with prospects narrowing at each stage.View full definition →, adapted for a regulated environment:

• Share of voice (SOV): a brand's proportion of total detailing (sales rep) visits or media impressionsimpressionsThe total number of times an ad or piece of content is displayed, regardless of clicks. Each display counts as one impression, even to the same person.View full definition → in a therapeutic class.
• Message recall: tracked via post-call surveys or panel data (e.g., from Veeva or IQVIA physician panels).
• NRx-eligible reach: the percentage of target prescribers (often the top 20% by volume, sometimes called "decile 8-10" physicians) who have been reached at least once.

Pharma companies concentrate spend on high-decile prescribers because prescribing is famously skewed: a small share of physicians often account for a large share of volume in a given class. This is why HCP segmentationsegmentationDividing a market into distinct groups of customers who share similar needs, characteristics or behaviours, so each group can be served with a tailored approach.View full definition → and targeting, not broad reachreachThe number of unique people exposed to your message in a given period. Unlike impressions, reach counts each person once, no matter how often they see it.View full definition →, dominate pharma marketing budgets.

Stage 2: sample requests and nbrx

NBRx (New-to-Brand prescriptions) is the single most watched number in a pharma launch. It counts prescriptions for patients newly starting therapy on this brand, as opposed to refills. It is the earliest signal that detailing and awareness are converting into actual prescribing behavior.

NBRx is tracked weekly using prescription claims data from vendors like IQVIA or Symphony Health, often at the individual physician level (with privacy safeguards under HIPAA, the US Health Insurance Portability and Accountability Act).

Worked example:

A brand runs 10,000 HCP details in month one. If 8% of detailed physicians write at least one new prescription that month, that's 800 NBRx-generating physicians. If each writes an average of 1.5 NBRx, that's 1,200 NBRx for the month. Marketing teams track this "conversion-per-detail" ratio to judge rep and campaign effectiveness, and it typically improves over a launch's first two to three quarters as awareness builds.

Stage 3: TRx and the refill signal

TRx (Total prescriptions) includes both new and refilled prescriptions. The ratio of NBRx to TRx tells you where a brand sits in its lifecycle:

• High NBRx, low TRx: early launch, lots of trial, not much repeat yet.
• Stable NBRx, rising TRx: healthy, growing patient base with good persistence.
• Falling NBRx, flat/declining TRx: saturation or share loss to a competitor.

TRx lift measures the incremental increase in total prescriptions attributable to a specific campaign or event (a conference sponsorship, a new co-pay program, an ad flight). It is usually estimated via geo-testing or matched-market comparisons, since a controlled experiment (like an A/B testA/B testA/B testing is a controlled experiment that compares two versions of something (A and B) by splitting traffic randomly to learn which performs better on a chosen metric.View full definition →) is rarely feasible when compliance rules constrain who receives what promotion.

Stage 4: The payer wall, prior authorization and access

Between "physician writes prescription" and "patient fills it" sits a friction point unique to healthcare: prior authorization (PA), where the insurer or PBM (CVS Caremark, Express Scripts, Optum Rx are the three largest in the US) must approve coverage before the drug is dispensed.

Industry estimates (as of recent years, treat as approximate) suggest that abandonment at the pharmacy counter, patients who get a prescription but never pick it up, can run 10-20% for specialty drugs, higher when out-of-pocket costs are high. This is why manufacturers invest heavily in:

• Co-pay cards / savings cards: reduce out-of-pocket cost for commercially insured patients (not usable with government insurance like Medicare or Medicaid due to anti-kickback rules under US federal law).
• Hub services: third-party programs that help with PA paperwork, benefits verification, and patient reminders.

Co-pay card activation rate (the share of eligible patients who actually register and use the card) is a key patient-funnelfunnelThe customer journey from awareness to purchase, typically Awareness, Interest, Consideration, Decision, Action, with prospects narrowing at each stage.View full definition → KPIKPIKey Performance Indicator, a measurable value that shows how effectively you're achieving a specific objective, tracked over time against a target.View full definition →, since an unused card is a wasted subsidy and a lost patient.

Stage 5: First fill and adherence

First fill is the patient-funnelfunnelThe customer journey from awareness to purchase, typically Awareness, Interest, Consideration, Decision, Action, with prospects narrowing at each stage.View full definition → equivalent of NBRx: the prescription actually gets dispensed. From there, marketing shifts to retention:

• Medication Possession Ratio (MPR) and Proportion of Days Covered (PDC): standard adherence metrics estimating what share of the time a patient has drug on hand, based on refill timing. A PDC above 80% is a commonly used industry threshold for "adherent."
• Persistence: how long a patient stays on therapy before discontinuing, often reported at 6 and 12 months.

For chronic therapies (statins, biologics for autoimmune disease), the CDC's resources on medication adherence are a good primer on why non-adherence is a major cost and outcomes issue that marketing-run adherence programs (text reminders, nurse support lines) are explicitly designed to address.

Putting the funnelfunnelThe customer journey from awareness to purchase, typically Awareness, Interest, Consideration, Decision, Action, with prospects narrowing at each stage.View full definition → together: a simplified view

| Stage | FunnelFunnelThe customer journey from awareness to purchase, typically Awareness, Interest, Consideration, Decision, Action, with prospects narrowing at each stage.View full definition → | Key metric | What it tells you |

|---|---|---|---|

| Awareness | HCP | Share of voiceShare of voiceYour brand's share of total advertising or conversation volume in your category, measured against competitors over a defined period., | Are the right doctors seeing/hearing about the brand |