Insights into Formulary Decision Processes, was conducted in the previous 12 months among the nation’s health plans and had a response rate exceeding 50 percent, including the top six health plans. This study is the first systematic and large-scale effort to examine how those participating in the health plan formulary decision making processes perceive the utility of the AMCP Format, compared to other methods used by drug manufacturers for submitting product information to health plans in advance of formulary consideration. The results from the survey clearly indicate that the AMCP Format has had a substantial impact. Over half of health plan pharmacy directors indicate that they are extremely familiar with the Format. Overall three-fifths of health plan pharmacy directors are familiar or extremely familiar with AMCP’s Format and among the largest plans – those representing more than 500,000 covered lives – almost ninety percent of plan pharmacy directors are familiar with the Format. Additionally, over one-third of all health plan pharmacy directors report that they request information from drug manufacturers in a form that is consistent with the AMCP Format. 

 

Data collection was performed by the National Opinion Research Center and data analysis was performed by Social & Scientific Systems, Inc.  Sean D. Sullivan PhD, Professor and Director, University of Washington Pharmaceutical Outcomes Research and Policy Program and Peter J. Neumann, ScD, Professor and Director, Center for the Evaluation of Value and Risk in Health, Tufts New England Medical Center served as the primary investigators. 

 

Cynthia J. Pigg, executive director and CEO of the Foundation, said, "Identifying medications that are able to deliver the greatest value to patients is a critical initiative. Over eight years ago, the Academy of Managed Care Pharmacy identified the need for standardizing the information used in the formulary decision making process.”  To meet this need, the Academy introduced the AMCP Format for Formulary Submissions in October 2000. The current version, 2.1, is available on the Foundation’s website, www.fmcpnet.org.  In addition, the Foundation has conducted over 50 training seminars on the use of the Format and the information obtained through its use for over 1400 managed care pharmacists and other health care professionals.        

 

Other highlights of the study include that with regard to safety and efficacy for labeled use, health plans were more likely to perceive information provided in the Format to be complete and clear or easy to understand, compared to information in other presentations. Information related to off-label use and costs and benefits was frequently perceived by plans to be incomplete, lacking in clarity and biased, regardless of the presentation. 

 

According to Ms. Pigg, “We are pleased with the level of awareness among health plans. Also, these findings represent the first study of this type that is national in scope and generalizable.  However, we also realize that there is still much work to be done. We will continue our efforts to provide insight into the formulary decision making process in order to deliver useful information that can be used to improve the value of investments in health care.” Efforts are already underway to conduct the survey with pharmacy benefit management companies, or PBMs.  

 

The study was funded by FMCP through research grants from Eli Lilly & Company, Johnson & Johnson Health Care Systems, Inc, Pfizer Inc, and TAP Pharmaceuticals, Inc.           CLICK HERE to download the study findings.