Best Practices in Formulary Success: Key Information that Payers want from Field Medical Teams

STUDY OVERVIEW

As the influence of payers has risen dramatically, pharmaceutical field medical team (FMT) interactions with payers also have risen in importance. The healthcare market is shifting to a value-based system; a new product’s position on a formulary is now as important as its reception among prescribers and KOLs. Recognizing this trend, pharma is paying more attention to the type of information that payers want and, more importantly, the information that will affect formulary decisions.

This study explores what types of information managed care organizations find most important for their formulary decision-making and how they are using the information related to formulary placement.

KEY TOPICS

• Executive Summary: Methodology, Participants, & Key Findings
• Information used for Formulary Decisions – How is it used and how is it useful?

KEY METRICS

• Rate in importance each type of information/data that you use that is provided by outside sources (manufacturers, vendors, etc.)
• Ratings provided for 21 information/data types (product efficacy & safety, managed care trends, clinical practice guidelines, compendia, comparative data, pricing analysis, etc.)
• Indicate how you use that information and why it is useful
  

• Similarly, respondents in MCOs and PBMs highly value three types of information for their decision-making:
  1. Product efficacy/safety information
  2. Comparative data and differentiating factors
  3. Clinical practice guidelines

This study engaged a total of 23 formulary leaders from at least 16 managed care organizations. Medical directors represented more than 40% of the respondents.

Industries Profiled:
Insurance; Health Care; Medical


Companies Profiled:
Anthem; Kaiser Permanente; CVS Health; WellSpan Health; DaVita; Aetna; Ascension; Cleveland Clinic; Express Scripts; Inc.; Tenet Healthcare ; Humana; MedImpact; HCA; UnityPoint Health; St. Joseph's Health; University Hospitals

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