1. Capabilities and Engagement Determine Opportunities with Key Payers
11/14/2018
Health Strategies Group
Author/Artist
Capabilities and Engagement Determine Opportunities with Key Payers
Across payers, level of sophistication and control, expertise in value and quality, and approach to innovation typically correlate with engagement opportunities for biopharmaceutical companies.
Aetna, Humana, and CVS Caremark remain high-opportunity payers for biopharmaceutical companies, given their ability to drive access, interest in value-based initiatives, infrastructure for advanced analytics, and consistent interest in biopharmaceutical company relationships and support.
EnvisionRx and Centene offer limited opportunities as they typically refrain from engaging with biopharmaceutical companies and lack sufficient sophistication and/or control to develop advanced relationships.
Aetna, CVS Caremark, and Humana Lead Payers in Capabilities and Engagement
Note: Capability includes scores from level of sophistication and control value and quality performance and approach to innovation; Engagement includes scores from biopharma engagement; Express Scripts, HCSC, MedImpact, Prime Therapeutics, and WellCare not shown due to insufficient data; however, their scores on certain components are available in the following sections. Blues plans do not include Anthem, HCSC, or Prime Therapeutics owner plans. Source: Health Strategies Group, Leading Health Plans and PBMs, January 2018.