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The Future of Payer Engagement: How Pharma Can Break Through

By Matt Sarnes, PharmD, Allen Lising

Payers and IDNs representing over 275 million covered lives access a single platform for pertinent product information. Learn how to meet them where they are.

Xcenda's Matt Sarnes and FormularyDecisions' Allen Lising share insight on the product information payers and other healthcare decision makers (HCDMs) find most valuable.

Q: How much progress has the healthcare industry made in driving meaningful dialogue on product value between pharmaceutical companies and formulary decision makers?

Allen Lising: As the number and complexity of products coming to market continues to increase, payers are asking for product information to guide their formulary planning and budget forecasting earlier in the development process.

Supporting the bi-directional exchange of information between payers and life science organizations is one of the keys to unlocking real value in pharmaceutical-led care by driving value-based reimbursement decisions. When we joined Xcenda last year, the most exciting aspect of combining the FormularyDecisions technology and payer community with Xcenda's leading global market access and health economics expertise was the opportunity to deliver more information on pipeline and approved products directly to payers, and deliver more actionable insights on payer needs to manufacturers.

Q: Where are you seeing the most activity in terms of information exchange between pharma and payers?

Matt Sarnes: Data from FormularyDecisions shows the therapeutic categories most reviewed by HCDMs in 2019 were oncology, neurology, infectious disease, rare diseases and autoimmune disorders. The high activity in these disease areas aligns with product launch activity in these categories, with oncology having 10+ products come to market in 2019.

Interestingly, HCDMs not only reviewed pre-approval product information, but also information on existing products in those same therapeutic categories. Of the almost 23,000 hits on oncology products in 2019, existing oncology product pages accounted for more than two-thirds of the page views. This likely reflects payers' need to understand both the new product and competitive products in that space.

The top product in terms of reviews by payers in 2019 was actually not an oncology product, but a rare disease product, Zolgensma, with almost 2,000 page views over the year.

Q: When are HCDMs most likely to review product information?

MS: For the first quarter of 2020, HCDM activity on the platform continues to align around product launches. In fact, five of the top 10 most reviewed products during the quarter launched in either Q4 2019 or Q1 2020. Our data also shows that HCDM activity around a new product or indication starts to increase significantly 4-6 months pre-launch and stays elevated through a five-month post-launch period.

Q: Where/how are payers accessing the information they need on these products?

MS: The use of FormularyDecisions among HCDMs continues to increase. That's on top of the existing base of 2,100 registered users representing 275 million covered lives. In 2019, we saw more than 1,200 logins per month. Session time — the amount of time a payer spends evaluating information, so to speak — also increased by 35% (or almost 30 minutes per session). This indicates that HCDMs are finding the relevant and consolidated information useful.

AL: Our community of payers has expressed the desire for manufacturers to put more information on the platform, especially during the pipeline phase when there is a dearth of information. When manufacturers add information to the platform, whether clinical trial information in the public domain or an eDossier for payers to request, we see double digit growth in overall product activity by HCDMs on those products.

FormularyDecisions continues to be a valuable centralized resource where HCDMs can conveniently access information when they need it and directly request more information from the more than 500 manufacturers connected to the platform as needed. More than 1,700 new dossier requests came through the platform in 2019. We also see a significant uptick in engagement with PIE webinars and other features that facilitate collaboration.

Q: What does the future look like for this kind of information exchange?

MS: Data from first quarter 2020 showed a greater than 100% spike in user activity in both March and April, with over 2,000 page views in the platform per working day. Even though the world was already on the path to various forms of digital engagement and immediate access to data, the COVID-19 pandemic certainly accelerated both innovation and consumption of technology in the healthcare space. Now that many manufacturers are finding themselves launching products in a virtual world, we'll no doubt continue to see use of the platform grow.

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About The Authors

Matt Sarnes, PharmD
Senior Vice President, Biopharma Services Strategy
Biopharma Services
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Allen Lising
Managing Director, FormularyDecisions
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