OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs
 

OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs

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Announcing OTCs Drugs in Managed Care: Taking the Pulse of MCOs and PBMs. This report will provide a detailed independent appraisal of complex issues related to promotion and coverage of OTC drugs in ...

Announcing OTCs Drugs in Managed Care: Taking the Pulse of MCOs and PBMs. This report will provide a detailed independent appraisal of complex issues related to promotion and coverage of OTC drugs in U.S. in the managed care setting. Research will be conducted by Kline’s analysts with executives at MCOs, PBMs, self-insured employer groups, OTC companies, public health advocates, attorneys, and consultants.

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    OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs Document Transcript

    • Healthcare 3rd Edition OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs To Be Published 2nd Quarter 2014 Base Year: 2013 Regional Coverage: United States This report will provide objective insights on complex issues surrounding promotion of OTCs among managed care organizations (MCOs) and pharmacy benefit managers (PBMs) including how these groups handle Rx-to-OTC switch brands, strategies for successful partnering between OTC companies and MCOs/PBMs, OTC promotion programs among MCOs/PBMs, and impacts of the Affordable Care Act on these plans and OTCs going forward. This Report Will Help Subscribers to: n Understand MCO’s/PBM’s perspective on OTCs and Rx-to-OTC switches n Learn about successful OTC/managed care promotional programs for OTC brands and potential pitfalls of such programs n Benchmark OTC companies can use to evaluate their current approach with managed care against that of their competitors www.KlineGroup.com Report #Y575A | © 2013 Kline & Company, Inc. n Gauge the impact managed care plans can have on OTCs, such as potential coverage for OTC brands, use of tiered copayments, coupons for OTC purchases, or use of FSAs to pay for OTCs n Help facilitate dialogue between your company and MCOs/PBMs
    • Healthcare OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs Tentative Report Contents* Introduction Promotional Programs n Executive Summary n n An Overview of key findings Forecasts and assessments Managed Care Overview n n n n n n Background on managed care environment Membership estimates for MCOs and PBMs Estimates on self-insured employers Rising costs of drugs for MCOs, PBMs, and selfinsured plans Impacts of Affordable Care Act on managed care plans and OTCs Key companies Rx-to-OTC Switches n n n n Changing Rx-to-OTC switch landscape Categories MCOs/PBMs view as potential switch candidates NSURE and FDA initiatives Programs that promote Rx-to-OTC switch brands in managed care settings www.KlineGroup.com n n n n n n Free-standing programs initiated by managed care plans Programs conducted in collaboration with OTC marketers Successful programs Pitfalls of such programs Perception of OTCs among MCOs and PBMs Strategies OTC companies can adopt to create win-win situations Variables to measure relative success or failure of such programs Coverage of OTC Drugs n n n n n Issues to consider Formulary issues and tiered copayments Member incentives Reduction in prescription drug utilization Levels of OTC coverage * Subject to charter subscriber input Report #Y575A | © 2013 Kline & Company, Inc.
    • Healthcare OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs Scope OTCs Drugs in Managed Care: Taking the Pulse of MCOs and PBMs will provide a detailed independent appraisal of complex issues related to promotion and coverage of OTC drugs in U.S. in the managed care setting. Research will be conducted by Kline’s analysts with executives at MCOs, PBMs, self-insured employer groups, OTC companies, public health advocates, attorneys, and consultants. From these interviews, we aim to provide: n MCO’s/PBM’s perspective on OTCs and Rx-toOTC switches n Details about successful OTC/managed care promotional programs for OTC brands and potential pitfalls of such program n Analysis of the impact managed care plans can have on OTCs such as potential coverage for OTC brands, use of tiered copayments, coupons for OTC purchases, or use of FSAs to pay for OTCs n Strategies for successful partnering with MCOs and PBMs in the future Key Benefits This report will assist OTC companies in identifying opportunities to promote their brands in the managed care setting. It will also serve as an invaluable tool in the strategic planning process. n Develop smart business strategies by understanding the trends and developments that are driving OTC/managed care partnerships n Benchmark your organization’s programs in managed care with those of your competitors n Facilitate discussions between your organization and MCOs and PBMs n n Capitalize on learning about pitfalls that may have happened in the past and how to avoid them n Ability to be dynamic and responsive to managed care groups by identifying trends expected to drive future trends and how these partnerships may evolve in the future Identify key managed care companies that may be most receptive to promotional programs for your OTC brands www.KlineGroup.com Report #Y575A | © 2013 Kline & Company, Inc.
    • Healthcare OTC Drugs in Managed Care: Taking the Pulse of MCOs and PBMs Methodology Kline’s approach places principal emphasis on primary research techniques to ensure that the foundation of business intelligence and insight is accurate, current, and reliable. Building on our 50-plus years in the business and leveraging our worldwide network of offices, our teams of seasoned professionals draw upon pragmatic industrial and commercial experience to understand and interpret global impacts and local perspectives. Primary Research We Know Who to Talk to. We Know How to Listen. A high number of in-depth discussions are conducted by each analyst. All interviews are done with true industry insiders. n Managed care organizations (MCOs) n Pharmacy benefit managers (PBMs) n Self-insured employer groups Our interviews engage experts across all pertinent fields and sectors including: n OTC companies n Regulatory agencies n Public health advocates n Attorneys and consultants Secondary Research We Know Where to Look – Mining the Details. Analysis is further supplemented by secondary research, consisting of constant tracking of annual company reports, national statistics bureaus, trade/ industrial/professional associations, and the like. Relevant developments are diligently followed and their impact closely monitored. Reports also draw upon non-confidential data from Kline’s internal database, consisting of over half a century’s syndicated research. Comprehensive Market Intelligence We Know How to Verify. Data are rigorously analyzed, cross-checked, distilled, and validated. Kline’s proven methodology allows exceptionally effective, precise, and reliable market intelligence procurement and assessment, giving subscribers a solid foundation on which to grow, refine, and expand their business with confidence. Kline Credentials A FULL SPECTRUM OF SERVICES Kline is a leading global management consulting and market research firm offering the complete spectrum of services. The firm has served the management consulting and market research needs of organizations in the chemicals, materials, energy, life sciences, and consumer products industries for over 50 years. MARKET MANAGEMENT CUSTOM n RESEARCH n CONSULTING RESEARCH REPORTS North America Latin America Europe China India Japan +1-973-435-3407 +55-11-3079-0792 +32-2-770-4740 +86-21-6012-6500 +91-124-4546-100 +81-3-3242-6277 www.KlineGroup.com Report #Y575A | © 2013 Kline & Company, Inc.