Specialty drugs fail on the second fill. The first fill happened at a clinic, with a nurse on the phone and a starter supply in hand. The second fill is a maze: a specialty pharmacy the person has never heard of, a prior authorization that expired, a copay card with its own rules, and a retail counter that says “we cannot fill this.” People abandon the dose. The claim shows up later, larger, somewhere else. The communication job is one path.
That path is also how you work on cost, through communication, without a lecture about trend. People need the same plain-language habit described in benefits education: what to do today, in order. Preventive visits are a different campaign, covered in preventive care communication. Specialty fills are a private, time-sensitive path for a smaller group. Write them that way.
One path, one number, one fallback
Write the path in the order a person will hit it. Who fills the drug: the specialty pharmacy, named, with the phone number that answers. What prior authorization means in one sentence: the plan must approve the drug before the pharmacy can ship it, and here is who starts that call. What a copay card is, if your plan allows one: a manufacturer program that may lower the amount due, and who helps enroll. What the nurse line is for: side effects, a missed dose, and a shipment that did not arrive.
Then write the fallback in its own line. If the pharmacy says it is not covered, do not pay cash and do not skip the dose until you have called this number. Put that number in the message and on the page. A person standing at a retail counter needs it without searching an intranet.
Keep the path short enough to screenshot. Five steps is a brochure. Three steps and a phone number is a fill. If your pharmacy benefit manager already has a concierge line, that line is the path. Send people there. Building a second set of instructions that conflicts with the PBM is how the second fill fails again.
Privacy: the text and the page do different jobs
Do not text the drug name. Do not put the condition in a lock-screen preview, a subject line, or a break-room flyer. A coworker should not be able to infer a diagnosis from a message you sent. The text or push, if you use one, says only: “If you take a specialty medication, start here.” The link opens a no-login page with that same sentence, the phone number, and a button to a logged-in or otherwise private page for the steps.
The private page can name the pharmacy, the prior-auth phone line, and what to do if a fill is rejected. Access it through a login, a one-time code, or a list you built with the PBM under your privacy rules. If you do not have a clean list of who is on a specialty drug, send the no-login pointer to everyone and let people self-select. A wrong guess mailed to a named employee is worse than a general door.
Managers do not get the drug name either. Their card says: if someone is having trouble filling a medication, send them to this number today, and do not ask what the medication is. That sentence prevents a huddle from becoming a disclosure. Align the text rules with SMS communication so consent and content stay tight.
Chronic care uses the same discipline
Condition programs, coaching, and diabetes or blood-pressure support fail the same way specialty drugs fail. The offer is real. The steps are scattered. People get a mailer, a portal tile, and a nurse they cannot reach after shift. Pick one front door. Say who it helps in language that does not diagnose the reader in public. Give the phone number and the hours. Say what happens on the first call.
Suppress people who already enrolled in the program if you can do it without broadcasting why they qualify. Invite the rest through the private page. A public poster can say that extra support exists for ongoing conditions and can point to the same no-login door. It should not list diagnoses.
Time the nudge to a moment that is already hard: a new plan year, a formulary change, or a rejected claim. A wellness-fair booth in May will not catch the person who is three days from a missed fill in February. Put the specialty path on the calendar next to January card issues and any mid-year formulary update. One reminder after a known rejection is worth more than a quarterly newsletter mention.
What to measure
Ask the PBM for second-fill rate, prior-auth turnaround, and abandoned shipments, before and after you publish the path. If you cannot get fill data yet, count calls to the number you published and tickets that say “the pharmacy said it is not covered.” A drop in those tickets, with the path held constant, is a usable early signal.
Share a short read with finance when a formulary or site-of-care shift is part of the renewal story. Keep the clinical detail out of the slide. The slide says: people had one number to call, and abandoned fills moved. The ROI page shows how employers frame that kind of result. LinQed Online can host the no-login door and the private steps so HR is not pasting phone numbers into a new PDF every January. Contact us if you want that path built with the number your PBM actually answers.
Key takeaways
- One path: specialty pharmacy, prior auth, copay card if you have one, nurse line.
- If the pharmacy says it is not covered, the next step is a phone number, today.
- The text says “if you take a specialty medication, start here.” It does not name the drug.
- Detail lives on a logged-in or private page. The public page is only the door.
- Chronic care nudges use the same public-versus-private split.
- Measure second fills and rejected-claim tickets.
Frequently asked questions
Can we text the name of the drug?
No. Texts, lock screens, and subject lines stay generic. Use “if you take a specialty medication, start here.” Put the pharmacy name and the steps behind a login or another private door. A drug name on a lock screen is a disclosure you cannot take back.
What if we do not know who takes a specialty drug?
Send the generic door to the workforce and let people self-select. Ask the PBM later for a privacy-safe way to reach the right group. Do not build a list from manager gossip or from a voluntary survey that asks people to name a diagnosis in a shared form.
What does the no-login page say?
That specialty medications have a different pharmacy path, the phone number to start, and a link to sign in for the steps. No condition names. No drug names. Hours for the phone line. The fallback line: if a pharmacy says it is not covered, call this number before you pay cash.
How is chronic care communication different?
The offer may be coaching or supplies, but the discipline is the same. One front door, one number, no diagnosis on the public message, and a measure that is enrollment in the program or a completed refill. A poster with a list of conditions is the version to retire.
Give people one pharmacy path and a phone number. Keep the drug name off the text.
A co-founder of Touchpoints with two decades of experience in employee benefits communication. He partners hands-on with benefits firms and employers nationwide to build strategies that deliver real outcomes.
