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Archives
December 2007: Lack of Impact from Two Key Generics in the Anti-depressant Formulary Market
October 2007: Formulary Position Differences between Commercial and Medicare Plans
September 2007: Impact of Patent Loss for Zocor on the Statin Marketplace
- Intro
- Formulary Access
- Trend Analysis
- Prior Authorization
- Quantity Limits
- Step Therapy
- Strategic Implications
Strategic Implications
What You Should Consider
Pharmaceutical companies need to monitor the Medicare and commercial markets separately and identify threats and opportunities for key accounts in each segment.
By understanding that certain therapeutic areas have significant differences in formulary coverage between Medicare and commercial plans, what contracting strategies should be employed across all lines of business?
What are the implications for those therapeutic areas that demonstrate meaningful differences between commercial and Medicare plans in formulary access coverage?
What pull-through or educational strategies should be employed to support physicians with prescribing decisions in therapeutic areas where prior authorization is more prevalent in commercial plans?
For drug classes subjected to significant restrictions, what are the rules and requirements for approval? How are complex restriction requirements best communicated to prescribers?