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Slide 1: The StrategicVision Report series Managed Care Trends and Strategies - The Voice of Managed Care on the State of Relations Between Managed Markets and the Pharmaceutical Industry and Opportunities for Partnership CBRSV010 Published Dec 2009 Evo lu tio n o f Ma n a g e d Ca re Ke y Eve n ts in th e His to ry o f Ma n a g e d Ca re Managed care has evolved over the past century to become a central part of the process of delivering health care to patients. Starting with the formation in 1917 of the first prepaid medical plan by physicians in cooperation with corporations and unions, and continuing with the establishment of Health Maintenance Organizations with governmental assistance in the 1970s, health care as we know it today has evolved through a series of events and legislations. Most recently, the initiation of Medicare Part D through the Medicare Modernization Act in 2003 has further sealed the relationship between managed markets and the pharmaceutical industry. Genesis of union and employer sponsored prepaid health plans First IPA formed, the San Joaquin Medical Foundation, in California California enacts legislation opening the door for Preferred Provider Organizations (PPOs) Part D drug benefit established by Medicare Modernization Act of 2003 1917 – 1940’s 1947 AMA convicted of anti-trust violations in attempt to curb prepaid medical organizations 1954 1970s 1982 1991 HEDIS 1.0 released 2003 Federal funds and policy promote Health Maintenance Organizations (HMOs )through HMO Act of 1973 Source: Managed Care Museum; Tufts Managed Care Institute 9 S h ift to Va lu e -Ba s e d Co n tra c tin g Today, managed care organizations are even more important as customers for pharmaceutical companies due to increased restrictions being placed on direct marketing to physicians. Working with managed care, pharmaceutical companies can open the door for drug usage and develop pathways towards fulfillment from physicians. Pharmaceutical companies need sound managed markets strategies in order to compete in today’s marketplace. • • A few pharmaceutical companies have made an endeavor into initiating value-based contracting as a target for account managers Value-based contracting strategy focuses on the bottom line, providing the best profit margin for the pharmaceutical company, regardless of formulary placement Access-Based Contracting Goal: Best Formulary Placement Preferred by Product Field Sales Forces due to preferred access Value-Based Contracting Goal: Best Profit Margin Will walk away from contracts if not profitable May not provide best formulary placement …built to support your business needs Tel: 732 631 0113 Fax: 908 845 0210 www.cbrpharmainsights.com email: info@cbrpharmainsights.com
Slide 2: Reasons to Purchase Enhance your knowledge of the key trends and strategies in working with your managed care customers Benefit from our primary research done directly with managed care organizations to best support your future strategies Get a pulse on which pharmaceutical companies are the leaders in managed care Table of Contents o o Executive Summary Managed Care: Vital Pharmaceutical Industry Customer o Evolution of the relationship between managed care and the pharmaceutical industry o Current state of the relationship between managed care and the pharmaceutical industry o Valuation of managed care within the pharmaceutical industry Servicing the Needs of Managed Care Organizations o Developing a customer focus o Understanding managed care priorities o Relationship management o Contracting principles o Pull-through Trends in Managed Care Contracting and Pull Through o Value-based contracting o Small molecules vs biologics o Specialty pharmacy Defining Leaders in the Managed Care Arena o Pharmaceutical company qualities valued in managed care o Top-rated Pharmaceutical Companies in:  Contracting  Pull-through  Programs  Innovation  Addressing needs of managed care  Overall managed care leadership Outlook for Managed Care and the Pharmaceutical Industry o Assessment of current state of the relationship between managed care and the pharmaceutical industry o Future trends and the potential impact on managed care o Developing managed markets strategy for future success Appendix Develop an understanding of which qualities exhibited by a pharmaceutical company are the most important in managed care marketing Enhance your managed care marketing strategy with insights from competitor activity o StrategicVision Report Pricing Options Include: Country license - $4,900 Global license - $9,310 o o The StrategicVision Report Series StrategicVision is CBR Pharma Insights’ premier pharmaceutical and biotechnology strategy-based report service o Driven by key industry trends and events, StrategicVision has been designed to keep you on top and ahead of the curve regarding how the pharmaceutical industry is changing and how these changes will impact your day to day business StrategicVision reports enable our clients to see a complete picture of the industry by covering the key issues being faced from both the R&D and Commercial perspectives o All StrategicVision reports are provided in “consultancy-style” presentation formats enabling our clients to utilize a very user-friendly deliverable to best support the need for use in everyday business processes CBRSV010 Managed Care Strategies and Trends …built to support your business needs Tel: 732 631 0113 Fax: 908 845 0210 www.cbrpharmainsights.com email: info@cbrpharmainsights.com