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Pharmaceutical technology assessment: perspectives from payers.

Musetta Y Leung1, Michael T Halpern, Nathan D West

  • 1RTI International, 1440 Main St., Ste. 310, Waltham, MA 02451-1623, USA. ian.dmleung@rti.org

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|April 4, 2012
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Summary
This summary is machine-generated.

Health plan payers use established processes for pharmaceutical technology assessment (PTA), prioritizing peer-reviewed studies and RCTs. Decision-making criteria for drug coverage and utilization management vary significantly across organizations.

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Area of Science:

  • Health economics and outcomes research
  • Pharmaceutical policy analysis
  • Health technology assessment

Background:

  • Evolving landscape of biologics, personalized medicine, and national drug policies necessitates advanced payer strategies.
  • Payers utilize diverse information sources for drug coverage and benefit design decisions.
  • Current understanding of formulary assessment processes and criteria by health plans remains incomplete.

Purpose of the Study:

  • To investigate the pharmaceutical technology assessment (PTA) process.
  • To identify stakeholders involved in decision-making.
  • To determine the timing, process, data considered, and outcomes of PTA.

Main Methods:

  • Exploratory study using a convenience sample of health plans, PBMs, and other relevant organizations.
  • Semistructured telephone interviews with medical and pharmacy directors (November 2009-April 2010).
  • Qualitative analysis and descriptive statistics to examine coverage, preferred choice, and utilization management.

Main Results:

  • Thirty-two respondents from 26 organizations participated.
  • Published peer-reviewed studies, technology assessments, and internal drug utilization data were highly valued.
  • Randomized controlled trials (RCTs) and systematic reviews/meta-analyses were preferred evidence types; economic and observational data received lower ratings.
  • Significant variation observed in evidence review processes, participant roles, and formulary/utilization management outcomes.

Conclusions:

  • U.S. health plan payers have defined PTA processes and specific evidence preferences.
  • Formulary decision-makers consider a wide array of information.
  • Factors influencing coverage and utilization management decisions differ across organizations and therapeutic areas.