1. Health Strategies Group
Key Finding #1
11/7/2018
Health Strategies Group
Author/Artist
Pricing, Net Costs Most Important Attributes in Plan Access Decisions; Groups Driven by Safety, Quality of Life
Health plans acknowledge that lower net pricing and impact on total cost of care are the most important drivers of access decisions in psoriasis, and predictive analysis confirms this.
The first thing is low net price compared to what's already on the market, that's number one. – National Plan Pharmacy
While efficacy demonstrated by PASI-reduction scores, as well as safety, also weigh heavily in decisions, plans most desire outcomes analysis and efficacy data tied to overall cost of care to use in product selection decisions.
I'd like to see outcomes based findings … whether it's a cap on total spend per patient or something around patients that discontinue treatment because they can't tolerate it … I'm open for more creative contracting. – Blues Plan Pharmacy
While efficacy is obviously a driving force in medical group product selection, groups indicate the most value is derived from strong safety profiles and improvements in quality of life.
However, predictive analysis derived from brand ratings and preferred status, indicate that net pricing significantly drives medical group access decisions, largely from improved access for perceived lower cost brands.
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