FMCP Updates Topline Research Report: Specialty Pharmacy Continues as Top Concern of Pharmacy Benefit Managers
The results of the fourth annual “Emerging Trends Driving Changes in Pharmacy Benefits” survey sponsored by the Foundation for Managed Care Pharmacy (FMCP) have been released. The survey is made possible through the generous support of Merck & Company. The HSM Group conducted the survey and analysis. Concerns about the management of specialty pharmacy continued to eclipse other issues in this year’s survey, both in terms of judging clinical evidence and cost management.
This year, in order to provide even more useful information to managed care pharmacy experts, the survey focused on two emerging trends: specialty pharmacy and value based benefits, two key areas of focus for your foundation. The survey did a “deep dive” on these two trends, meaning that there were additional questions in these areas. The topics of eHIT, e-prescribing, disease management, pay for performance, consumer directed healthcare and emerging formulary benefit designs were also included in the survey and these areas were “popcorn” questions, meaning that there were only a few quick response questions in these areas. Questions reflective of current events were added and historical questions that were no longer “hot topics” were eliminated.
We hope you find the information interesting and useful. You should also know that your customers are most interested in the results of the survey and we are sharing the results with employers nationwide.
Thank you to each of you who responded to the survey. This generous sharing of your time and talent serves to help shape your foundation’s agenda to ensure our research and education efforts improve the public health and help you stay current in our profession.
To access the report CLICK HERE
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Here are some of the highlights of the survey:
Overall Trends
w Specialty formulary management continues to be the most critical initiative to implement successfully over the next two years, with nearly one-third of respondents ranking this #1.
w A significantly higher percentage of 2009 respondents (27%) believe it is critical to implement eHIT initiatives successfully compared to 2008 (14%).
w Not surprisingly, health care reform is the most important emerging issue expected to have an impact on the future of managed care pharmacy for over two-thirds of respondents.
Specialty Pharmacy
w Top anticipated outcomes of disease/care management for patients using specialty pharmaceuticals are compliance (84%), cost control (78%), utilization management (69%), and driving outcomes (67%).
w Nearly one-third of respondent organizations have specialty pharmacy education programs in place. One in five expect to launch programs by end of 2010.
w Most frequently mentioned tools and assistance needed for specialty pharmacy efforts were best practices (70%), forecasting impact of pipeline drugs (63%), specialty Rx standards (56%), and utilization estimation tools (56%).
w Only 14% currently use reference-based contracting for specialty pharmacy and one in five do not plan to use it at all.
Value-Based Benefits
w There has been a significant increase in the offering of value-based benefit packages since 2007 (26% vs. 5% in 2007).
w Five design components increased significantly in 2009: formulary designs customized to specific disease states, helping employers determine at-risk employees, targeted education to at-risk beneficiaries, integrated benefit data, and specific provider network management.
w Purchasers continue to be the primary drivers of value-based benefits. Employee benefit consultants, not mentioned in 2008, are the fourth most frequently mentioned drivers in 2009.
w Nearly three-quarters of respondents believe that data integration is the most critical component of value-based benefit design. Medical and pharmacy data are integrated in-house at over half of the organizations. Data are not integrated at one in five organizations.
P4P
w Maximizing generic product use was the most mentioned expected gain (38% in 2009) for organizations with P4P programs for network physicians, consistent with previous years. Maximizing formulary products use was mentioned by one-third of respondents.
Disease Management
w Within the next two to three years, a third of respondents expect to transition from a disease-specific approach to a patient-centered approach, while 20% expect to focus on separate disease-specific DM programs. Six percent currently provide a patient-centered approach in their DM programs.
eHIT
w A quarter of respondents expect to offer EMR/EHR patient data systems within the next three years. Coupled with the 24% that currently have EMR, about half of respondent organizations should have such eHIT systems.
w Significantly more respondents say their organization currently has physician/provider use of point-of-care PDA operational (45%), compared to 2008 (26%). The same is true for a broker portal, which 54% of organizations offer in 2009, compared to 36% in 2008.
ePrescribing
w The number of organizations with fully integrated ePrescribing programs increased significantly in 2009 (36%), compared to 2008 (20%) and 2007 (22%).
CDH
w Over a third (38%) of respondent organizations currently manage CDH plans for beneficiaries. There is little change in total membership for organizations in 2009 (13%) compared to 2008 (14%), but slightly more anticipate an increase in enrollment in the next year (2009=17%, 2008=14%).
Questions? Contact Richard Fry, FMCP Director of Programs, (703) 683-8416
