Research and Markets: Formulary Decision Making in the United States

DUBLIN--(Business Wire)--
Research and Markets
(http://www.researchandmarkets.com/research/d8b06b/formulary_decision) has
announced the addition of Decision Resources, Inc.'s new report "Formulary
Decision Making in the United States" to their offering.

The U.S. pharmaceutical industry is facing the worst combination of pressures in
memory-the most severe recession in decades, a dramatic slowdown in
pharmaceutical sales, a new U.S. administration intent on slashing healthcare
costs, and a host of blockbuster patent expirations. In this exceptionally
challenging reimbursement environment, manufacturers must have a thorough
understanding of the formulary decision-making process. This report uses data
from 13 different surveys to examine how pharmacy and therapeutics (P&T)
committees make coverage decisions.

Get the Answers You Need to Shape Your Strategy

* P&T committees are generally entrusted with the responsibility for formulary
decision making in the United States. Who are the key players in P&T committees?
How frequently do these committees meet, and when do they begin formulary
decision making for new drugs? What role do pharmacy benefit management
companies (PBMs) play in decision making?
* In 2000, the Academy of Managed Care Pharmacy introduced the Format for
Formulary Submissions, a template for manufacturers' formulary submissions. How
do managed care organizations (MCOs) and manufacturers compare in their opinions
regarding the Format's uptake and value. What changes would MCOs like
manufacturers to make to their reimbursement dossiers?
* Efficacy is generally by far the most important factor in formulary decision
making. What other criteria carry particular weight with P&T committees? How
does formulary decision making vary by indication? What factors have a bearing
on tier placement within formularies?
* The reimbursement environment in the United States is expected to undergo
dramatic changes in the coming decade. How does the new U.S. administration plan
to promote the use of generics and biosimilars? How will government funding for
comparative effectiveness research influence formulary decision making? How are
MCOs likely to respond to the launch in the United States of the first
biosimilars? How can the pharmaceutical industry respond to this changing
environment?

Scope

* Identity of formulary decision makers: role and composition of P&T committees;
frequency of P&T committee meetings; timing of formulary decision making; role
of PBMs.
* Academy of Managed Care Pharmacy's Format for Formulary Submissions: origins
and objectives; frequency of use; MCO assessment of the quality and value of
submissions based on the Format; common criticisms of manufacturer dossiers.
* Key factors in formulary inclusion and tier placement: most important criteria
overall; case studies of hospital anti-infectives, HIV therapies, rheumatoid
arthritis (RA) biologics, and obesity therapies; factors influencing tier
placement; decision making for specialty pharmaceuticals.
* Outlook and implications for the pharmaceutical industry: regulation of
generics and biosimilars; comparative effectiveness research; changes in benefit
design; coverage of biosimilars; pharmaceutical industry responses to the
changing environment.

Key Topics Covered:

* Executive Summary
* Introduction
* Identity of Formulary Decision Makers
* Academy of Managed Care Pharmacy's Format for Formulary Submissions
* Key Factors in Formulary Inclusion
* Key Factors in Tier Placement
* Specialty Pharmaceuticals
* Outlook and Implications for the Pharmaceutical Industry
* List of Figures

Companies Mentioned:

* Academy of Managed Care Pharmacy (AMCP)
* Amgen
* Bristol-Myers Squibb
* Centers for Medicare and Medicaid Services (CMS)
* Foundation for Managed Care Pharmacy (FMCP)
* Genentech
* HSM Group
* ImClone Systems
* Medco Health
* National Institute for Health and Clinical Excellence (NICE)
* Pfizer
* Pharmaceutical Care Management Association (PCMA)
* Pharmaceutical Research and Manufacturers of America (PhRMA)
* Pharmacy & Therapeutics Society
* Social & Scientific Systems

For more information visit
http://www.researchandmarkets.com/research/d8b06b/formulary_decision.

Research and Markets
Laura Wood
Senior Manager
press@researchandmarkets.com
Fax from USA: 646-607-1907
Fax from rest of the world: +353-1-481-1716

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