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SM 187A Managed Care Pull Through Report Summary

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  • 1. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market ShareManaged Care Pull-ThroughExcellence: From Formulary AccessTo Increased Market SharePROJECT BACKGROUNDIn the current payer-driven pharmaceutical Industry Analysismarketplace, companies not only have to 24 benchmarked companies in the pharmaceutical, biotech and medicalfight to win product placement on device industriesmanaged care formularies but also to “pullthrough” the business after a formulary Information Typeswin. To benefit from favorable managed • 4 Information Graphics • 19 Data Graphicscare positioning, savvy companies ensure • 250+ Metrics • 19 Manager Narrativestheir sales forces, account management • 40 Best Practices • 2 Response Matricesand marketing teams have the necessaryskills, tools, resources and programs to Report Lengthpull through demand and grow market 85 pagesshare for the preferred products after awin.Pharmaceutical, biotech and medical device companies “pull-through” sales withcomplex, coordinated programs and events that communicate to doctors,pharmacists, patients and large employers about the formulary change andproduct benefits.Best Practices, LLC, undertook this research to investigate pull-throughchallenges and the best practices that companies have developed to overcomethem. The results include quantitative benchmark metrics and qualitativeexecutive insights on pull-through operations at leading companies. The researchwill enable pull-through managers and directors to identify and close programBest Practices, LLC © (919) 403-0251 1
  • 2. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market Sharegaps and discover success factors that they can Study Participantsuse to develop program excellence. • Abbott Laboratories • AlconSTUDY METHODOLOGY • • Allergan AstraZeneca • BayerResearch involved a survey of 33 pull-through • Boehringer Ingelheim • Calderaleaders at 24 companies within the • Daiichi-Sankyopharmaceutical, biotechnology and medical • Galdermadevice industries. Best Practices analysts also • GlaxoSmithKline • Johnson & Johnsonconducted a series of in-depth interviews with • Merck & Co.selected to uncover insights and identify • Novo Nordisksuccessful tactics and practices for achieving • Perkin Elmerformulary pull-through. The survey was focused • Pfizer • Sanofi-Aventison collecting quantitative data, while interviews • Smith & Nephewcollected qualitative data, process descriptions • Solvayand executive insights. • Takeda • Taro • TibotecThis research is focused on several major topic • Upsher-Smithareas including: • Wyeth Pharmaceuticals • Xanodyne• Contracting strategies that support pull- through results• Collaboration across corporate channels and functions• Effective internal and external communication processes and tools• Customer segmentation• Customer communication topics, channels and timing• Effective activities and programs• Key Opinion Leader management• Use of program evaluation metrics• Trends in pull-through resource levels• Key challenges faced in accomplishing managed care pull-through• Best practices for achieving managed care pull-through resultsBest Practices, LLC © (919) 403-0251 2
  • 3. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market ShareSAMPLE FINDINGSAmong the findings that emerged from this research are the following:• Programs: Pull-through programs can be highly effective at driving results. In rating four types of pull-through programs, 45 percent of benchmark participants gave the top rating of high impact to general pull-through support programs (aimed at increasing provider awareness of products), while 24 percent rated therapeutic intervention programs and 23 percent rated education support programs high impact. In contrast, only 4 percent found adherence/persistency programs to have a high impact.• Targeted Audience: Companies most frequently aim their pull-through efforts at physicians (97 percent) and physicians’ staff (79 percent), but patients, health plan members, government agencies and large employers are also common pull-through targets.• Measurement: Continual measurement of pull-through results helps companies understand the true cost (ROI) of the market share gained with their pull-through initiatives. In addition, regular and consistent measurement and analysis enable pull-through leaders to identify and rapidly change ineffective activities and strategies and improve results. Yet good measurement practices are a challenge for most of the participating companies.REPORT EXCERPTS Preferred Channels for Customer Education Benchmark participants deliver education programs to their customers through an array of different channels, ranging from websites to direct mail. The rationale for multichannel communication may be driven in part by the desire to reach (1) different customer segments, asBest Practices, LLC © (919) 403-0251 3
  • 4. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market Share well as (2) customers with varying channel format preferences. However, another driver may be that none of the individual channels is viewed as highly effective in getting the pull-through message out. Less than a quarter of respondents judge any channel as highly effective, with the exception of special events (such as screenings or health fairs), which were seen as highly effective by only 33 percent of benchmark participants. Websites, Special Events Effective for Customer Education Q. Please rate the effectiveness of the following channels/media for delivering education programs to customers? (Choose one for each channel/medium.) Channel Effectiveness Other: Highly Effective Moderately Effective • Call center Total support for Effective patients Websites 3% 81% 84% • Web training • Mobile tech Special events (e.g., screenings, 76% 33% 43% • KOL speakers health fairs, fitness events • Roundtables Patient handouts 13% 50% 63% • Patient letters • Patient Instructional videos 21% 41% 62% assistance/ scholarships 55% 58% • Non-branded E-mail flashes 3% disease awareness 48% 54% modules Direct mail 6% • Detailing. (n=29-32) % RespondentsCopyright © Best Practices®, LLC BEST PRACTICES, ® LLCFigure 1: Websites, Special Events Effective for Customer Education Websites are the channel with the highest overall effectiveness score, with 84 percent finding them either moderately (81 percent) or highly (3 percent) effective. Instructional video are seen as highly effective by 21 percent and patient handouts by 13 percent. Although widely used, direct mail and email flashes received the lowest ratings with around half rating them moderately effective and few rating them higher. Best Practices, LLC © (919) 403-0251 4
  • 5. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market Share Other channels the benchmark class uses effectively include roundtables, call center support for patients, web training, mobile tech, patient letters, patient assistance/scholarships, non-branded disease awareness modules, detailing and KOL speakers. Changing Resource Levels for Pull-Through Pull-through is clearly a high priority in the payer-dominated market today, with many more companies experiencing increases rather than cuts in resources. Despite the slow economy, 67 percent of participating companies expect to see pull-through resources increase over the next two years—nearly as many as the 69 percent that saw actual increases in the last two years. Moreover, nearly one -hird expect increases of 10 percent or more in the near future, compared with about a quarter that saw increaes that large in the preceding two years. Majority Expects Recent Resource Increases to Continue Q. Please estimate the level of change in resources (budget and staff) for pull-through activities and programs you have seen over the past two years. Also estimate the level of change in pull-through resources you anticipate for the next two years. (Choose one for each time period.) Pull-Through Resource Levels Actual Change Anticipated Change Previous 2 Years Next 2 Years 19% 17% Decrease >10% 0% 0% 10% Decrease 1-10% 17% No Change 45% 37% Increase 1-10% 69% 67% Increase >10% 24% 30% (n=29) (n=30) % Respondents % Respondents Copyright © Best Practices®, LLC BEST PRACTICES, ® LLCFigure 2: Majority Expects Recent Resource Increases to ContinueBest Practices, LLC © (919) 403-0251 5
  • 6. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market Share A minority of benchmark partners—17 percent—anticipate any form of budget or staff cuts whatsoever for pull-through on the horizon. All of those partners expect cuts of at least 10 percent from the current levels. Those who are experiencing decreasing resources made a number of comments about facing subsequent budget and personnel reductions. Among those are the following: • “Budget constraints are slowing down our efforts to develop new media to reach physicians.” • “Cuts have hurt our ability to do lunches and educational events.” • “Our competitors have a better ratio of reps to customers. We are spread very thin.” Over the past two years, 19 percent of survey respondents saw a decline in resources averaging above 10 percent, compared with more than two-thirds whose resources increased. Approximately 10 percent of the benchmark class experienced no change. Projections for resource levels expected over the next two years followed a similar pattern.SAMPLE BEST PRACTICE 6. Coordinate across all the “5 Ps” to engage all external stakeholders and avoid pull-through disconnects. One key to successful pull-through is understanding that there are many different healthcare decision- makers who each play a part in ensuring that a patient can access the appropriate medicines. If any one of these is unaware of a formulary change, the preferred product may not get into the patient’s hands as intended by the plan. “Budget constraints are slowing down our efforts to Patients, physicians, pharmacists, payers and plan develop new media to reach physicians.” sponsors (including employers, Medicare and --Global Franchise Director Medicaid) all make healthcare decisions, and pharmasBest Practices, LLC © (919) 403-0251 6
  • 7. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market Share must reach all these “5 Ps” to “There are many potential gaps along prevent gaps in the flow of on- the way and you have to prevent the formulary medicine to the intended patient from falling through them.” --Interviewed Account Manager patient. Savvy companies align the Ps after a win and keep them informed on a regular basis through using multiple communication channels – including emerging social and professional networking media. After a plan has been engaged through contracting, companies must work closely with the plan to develop a communication strategy that encompasses all decision-making groups. Said an interviewed Account Manager: “You have to pay attention to every one of these groups and make sure they know about the updates and understand the formulary and product benefits. A doctor may prescribe the right product, but the pharmacist may change it. There are many potential gaps along the way and you have to prevent the patient from falling through them.” Include All External Stakeholders in Formulary Outreach Key Healthcare Decision Markers: The 5 Ps Patients Patients Physicians/ Physicians/ Pharmacies Pharmacies Prescribers Prescribers Pull-Through Pull-Through Engagement Engagement Plan Plan Payers Payers Sponsors Sponsors Patients Physicians/ prescribers Pharmacies (including mail order) Plan Sponsors (employers, Medicare, Medicaid) Payers/Plans Additional stakeholders include 3rd party administrators, employee benefit consultants, therapeutic area educators, KOLs and physician office staff. Copyright © Best Practices®, LLC BEST PRACTICES, ® LLCFigure 3: Coordinate 5 Ps to Prevent Gaps between Patient and ProductBest Practices, LLC © (919) 403-0251 7
  • 8. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market ShareREPORT STRUCTURE AND ORGANIZATION The project findings are organized into six sections: • Executive Summary: The executive summary explains the survey objective and methodology, identifies participating companies, provides definitions, and reports key findings and insights. • Building an Effective Pull-Through Operation: This section discusses how companies establish structures and processes that optimize pull- through. Areas covered include pull-through leadership, planning, training, staff roles, cross-channel and cross-functional collaboration, internal communications processes and tools, use of templates, effectiveness metrics, and trends in budget and staffing levels. • Pull-Through in Action: The section examines programs and activities that companies use to increase pull-through effectiveness. Contracting strategies, effective messaging, customer segmentation, effectiveness metrics, KOL management, and communication topics, channels and timing are among the topics covered. • Key Challenges Faced in Accomplishing Pull-Through: Participants share the current challenges they face in their efforts to increase pull-through. • Best Practices for Pull-Through Excellence: This section highlights the best practices for pull-through that were shared by participants in survey responses. • Appendix: Includes matrices of full responses to best practices and key challenges questions. Includes survey instrument.Best Practices, LLC © (919) 403-0251 8
  • 9. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market ShareABOUT BENCHMARKINGREPORTS.COM BenchmarkingReports.com is a service of Best Practices, LLC, world leader in benchmarking research and analysis. BenchmarkingReports.com provides vital insights and data from our primary research at a fraction of original project cost. Best Practices, LLC has conducted pioneering benchmarking research for top companies since 1991, providing clients with "Access and Intelligence for Achieving World-Class Excellence." To learn how we can help you find solutions to your current business issues, visit our site at www.best-in-class.com.Best Practices, LLC © (919) 403-0251 9
  • 10. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market ShareTABLE OF CONTENTS REPORT STRUCTURE AND ORGANIZATION 5 Executive Summary ....................................................................................................... 6 INTRODUCTION 6 RESEARCH FOCUS 6 RESEARCH APPROACH 7 PARTICIPATING COMPANIES 8 KEY INSIGHTS 10 KEY FINDINGS FROM SURVEY 12 DEFINITIONS FOR TERMS USED IN THIS STUDY 16 Building an Effective Pull-Through Operation......................................................... 17 PROGRAMS THAT DRIVE PULL-THROUGH 17 EFFECTIVE TOPICS FOR PULL-THROUGH EDUCATION 23 PREFERRED CHANNELS FOR CUSTOMER EDUCATION 25 KOL INTERACTION IMPACTS PULL-THROUGH EFFECTIVENESS 26 PULL-THROUGH LEADERSHIP 32 CHANGING RESOURCE LEVELS FOR PULL-THROUGH 36 Pull-Through in Action................................................................................................ 39 KEY STEPS TO PULL-THROUGH PROGRAM EXCELLENCE 39 Manage pull-through complexity by working to a detailed process model that provides a template for rapid, effective response to a formulary win. 41 Use contract requirements to gain timely plan support for pull-through activities and programs. 43 Foster, recognize and reward cross-company collaboration—especially between Sales and Marketing. 46 Provide field force training on Managed Care basics, as well as on the specifics of each pull-through initiative. 49 Improve physician access with messages that highlight both the product’s clinical benefits and formulary advantages. 52 Coordinate across all the “5 Ps” to engage all external stakeholders and avoid pull- through disconnects. 54 Maintain frequent cross-company communication to ensure that all internal channels and functions can collaborate effectively on pull-through. 57 Continually measure and analyze results to understand ROI and to rapidly identify and adjust ineffective strategies and tactics. 59 Key Challenges in Achieving Pull-Through .............................................................. 63Best Practices, LLC © (919) 403-0251 10
  • 11. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market ShareLIST OF FIGURESFigure 1: Participating Companies .............................................................................................................. 7Figure 2: Participant’s Job Titles................................................................................................................. 8Figure 3: Job Level and Function/Department of Participants.................................................................... 9Figure 4: Therapeutic Areas Represented ................................................................................................... 9Figure 5: Multiple Programs are Used to Generate Pull-Through ........................................................... 18Figure 6: Programs Help Companies Capitalize on Formulary Wins ....................................................... 19Figure 7: Efficacy Benefit Leads Therapeutic Intervention Tactics......................................................... 20Figure 8: Top Adherence/Persistency Driver is Patient Education ........................................................... 21Figure 9: Companies Target Multiple Customer Groups Beyond Providers........................................... 22Figure 10: Clinical Data and Practice Guidelines are Best Provider Topics ............................................. 23Figure 11: Co-Pay and Adherence are Best Topics for Patient Education ................................................ 24Figure 12: Preferred Education Topics for Providers and Patients .......................................................... 25Figure 13: Websites, Special Events Effective for Customer Education .................................................. 26Figure 14: KOL Interactions Can Have High Pull-Through Impact ........................................................ 27Figure 15: Educators Play Important Pull-Through Role.......................................................................... 28Figure 16: Most Used Tools and Templates are for Accounts and Education ......................................... 29Figure 17: Tools and Templates Boost Pull-Through Effectiveness......................................................... 30Figure 18: Few Characterize Their Tools and Processes as Excellent ...................................................... 31Figure 19: Account Managers Most Often Lead Pull-Through Efforts..................................................... 33Figure 20: Sales and Account Manager Roles are Distinct but Changing................................................. 34Figure 21: Use District Managers to Maintain Pull-Through Momentum ............................................... 35Figure 22: Sales is the Primary Home of Pull-Through Employees ......................................................... 36Figure 23: Majority Expects Recent Resource Increases to Continue....................................................... 37Figure 24: Critical Practices for Achieving Pull-Through Excellence ...................................................... 39Figure 25: Eight Steps to Pull-Through Excellence ................................................................................. 40Figure 26 : Manage Complexity by Working to a Detailed Process Model.............................................. 42Figure 27: Use Contact Requirements to Gain Timely Support from Plan ............................................... 43Figure 28: Foster and Develop Cross-Company Collaboration on Pull-Through ..................................... 46Figure 29: Train Sales on Managed Care Basics and Pull-Through Specifics .......................................... 49Figure 30: Most View Pull-Through Training as Sufficient ..................................................................... 50Figure 31: Performance Boosters .............................................................................................................. 51Figure 32: Improve Physician Access with Clinical + Formulary Message.............................................. 53Figure 33: Coordinate 5 Ps to Prevent Gaps Between Patient and Product .............................................. 54Figure 34: Include All External Stakeholders in Formulary Outreach...................................................... 55Figure 35: Maintain Frequent Communication to Ensure Internal Alignment.......................................... 57Figure 36: Use Internal Website to Support Pull-Through Teams ............................................................ 58Figure 37: Continually Measure Results to See ROI and Make Improvements........................................ 60Figure 38: 96 Percent of Participants Use Market Share to Measure Effectiveness ................................. 61Figure 39: Market Share is the Most Important Success Indicator ........................................................... 62Figure 40: Top Pull-Through Challenge is Field Coordination/Training.................................................. 63Figure 41: Challenges – Field Coordination, Training and Momentum ................................................... 64Figure 42: Challenges – Limited Physician Access/MD Ambivalence..................................................... 65Figure 43: Measuring Return on Pull-Through Investment ...................................................................... 66Figure 44: Challenges-Resource Limits, Plan Support & Compliance ..................................................... 67Figure 45: Provider Outreach is Top Area for Pull-Through Best Practices............................................. 68Figure 46: Best Practices - Physician/Provider Focus............................................................................... 69Figure 47: Best Practices – Messaging, Collateral and Communication................................................... 70Figure 48: Best Practices - Goals, Measurement & Analysis.................................................................... 71Figure 49: Best Practices – Internal and External Collaboration .............................................................. 72Figure 50: Best Practices- Process, People & Programs ........................................................................... 73Best Practices, LLC © (919) 403-0251 11
  • 12. Report Summary: Managed Care Pull-Through Excellence – From Formulary Access to Increased Market ShareORDER FORM I’d like to order the following Best Practice Benchmarking Report.® ID PUBLICATION TITLE QUANTITY PRICE SUBTOTAL Managed Care Pull-ThroughSM-187 Excellence: From Formulary Access to Ordering Increased Market Share 3 or more reports Deduct 10 percent Options Shipping and Handling: Add $48 per report ONLINE TOTAL benchmarkingreports.com PHONE SHIP TO: (919) 403-0251 Name FAX Title (919) 403-0144 Company EMAIL Street Address bestpractices@best-in- class.com City/State/Country Zip MAIL Phone Fax Best Practices, LLC 6350 Quadrangle Drive Email Suite 200 Chapel Hill, NC 27517 PAYMENT OPTIONS: Check enclosed payable to “Best Practices, LLC” Visa MasterCard American Express Card Number Exp. Date Authorized SignatureBest Practices, LLC © (919) 403-0251 12