Optimizing Managed Care Group Resources

To ensure organizational health and competitiveness, pharmaceutical and biotechnology leaders must continually identify optimal resource levels. Sometimes the need is to grow resources. At other times, the need is to defend or shrink resources. This benchmark study provides managed care leaders with important benchmarks on the optimal size of U.S. Managed Care groups linked to activities performed to allow managed care leaders to assess their efficiency level relative to peers.

For the purposes of this study, Managed Care is defined as pharmaceutical or biotechnology groups that serve the following customers: MCOs, PBMs, Trade/Wholesale, Hospitals/IDN, Public payers (VA, DoD, Federal Accts), Clinics (e.g. dialysis) and Specialty Pharmacies.

Industries Profiled:
Biotech; Chemical; Pharmaceutical; Medical Device; Health Care


Companies Profiled:
Genentech; Roche; NovoNordisk; GlaxoSmithKline; Eli Lilly; Forest Laboratories; Johnson &Johnson; Biovail; Proctor&Gamble; Pfizer

Study Snapshot

This research originated from a Best Practices, LLC research and consulting project. It was conducted for a pharmaceutical client and was based on surveys with executives and senior managers from pharmaceutical and biotech organizations.

Key topics include:

Staffing data (FTE), outsourcing, budget and efficiency metrics were gathered for the following activities performed by Managed Care groups:

• Account Management
• Customer Marketing Strategy (sets contract strategy, liaison to brand teams)
• Contract Management (back office support)
• Customer Market Research (specific to managed care customers)
• Customer Program Management (e.g., disease management or value-added programs)
• Pharmacy Relations
• Public payer Pricing (Implementation of rebates/chargebacks for Medicare/Medicaid/DoD/VA).

If you purchase Best Practice Database document(s), you will have 30 days from the date of purchase to apply some or all of the cost of the document(s) toward the cost of a Full Access Individual, Pharma, Group or University Membership. Write us at DatabaseTeam@bestpracticesllc.com or call David Guinn at 919-767-9179 if you have any questions.