Not satisfied with your prescription medicine? Then demand a refund.

Unlikely as it may sound, money-back guarantees could be the next big thing in marketing pharmaceuticals, according to some Danish experts.

Professor Claus Moldrup of the Danish University of Pharmaceutical Sciences, Copenhagen, thinks that a system of not paying for a drug unless it works would be good news, not only for patients and healthcare funders, but also manufacturers.

Currently, a large percentage of all medicines prescribed do not have the desired effect for a variety of reasons, including the wrong choice of drug, genetic factors and adverse interaction with other treatments.

A money-back approach would tackle this by forcing drug companies to ensure the right drug gets to the right patient, Moldrup said.

“A no cure, no pay strategy creates a win-win situation for the authorities as well as the drug industry, and thus patients, because in a competitive environment only the best drugs will win,” he wrote in the British Medical Journal.

By definition, drug firms will only give such guarantees for products that are effective in a large proportion of patients, since otherwise the cost could be prohibitive.

Some companies are already trying out the idea.

NOVARTIS SUCCESS

Switzerland’s Novartis AG last year offered U.S. patients their money back if they did not see a reduction in high blood pressure after using its hypertension drugs Diovan and Lotrel.

Patients who fail to reach a target set by their doctor get reimbursement of up to four months of their out-of-pocket drug costs under the “take action for healthy blood pressure” programme.

A Novartis spokesman said the programme had been successful in driving an increase in prescriptions for its medicines.

Other companies that have tried out the concept include U.S.-based Eli Lilly and Co, which last July offered to pay for a competing product if men were not satisfied with its anti-impotence pill Cialis.

Bayer AG, meanwhile, launched a refund this year for men in Denmark who were not satisfied with its impotence drug Levitra.

Overall, however, Moldrup said the pharmaceutical industry had been slow to embrace the idea of drug refunds for dissatisfied customers, with only eight schemes launched in the past decade.

But he believes that could be about to change in face of tougher market conditions, with governments bearing down on healthcare costs and doctors wary of sales pitches from manufacturers.

“Now that drug representatives’ access to doctors is being limited, and doctors are increasingly reluctant to accept direct marketing initiatives, the pharmaceutical industry will have to start considering alternative business models,” Moldrup said.

The approach is most likely to be adopted when the effect of a drug can be easily assessed and it faces heavy competition from several “me-too” products, he said.