Commercial Health Plans: Manufacturer Competitive Assessment and Contracting for Oncology Medications

Commercial Health Plans: Manufacturer Competitive Assessment and Contracting for Oncology Medications

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Oncology medication manufacturers have increased efforts to build collaborative engagements with commercial health plans as the marketplace becomes notably more competitive. HIRC's report, Commercial Health Plans: Manufacturer Competitive Assessment and Contracting for Oncology Medications, assesses the contracting environment and provides commercial health plans' evaluation of 22 manufacturers active in oncology. The report addresses the following questions: 

  • Which pharmaceutical firms are most often nominated as "Partner of Choice" in oncology? Why? 
  • How do manufacturers benchmark in quality of account support and programs and truly understanding customers' needs and challenges in oncology?
  • How do managed care decision-makers perceive the current contracting environment? Which contract types are most prevalent for oral and IV medications?
  • Which pharmaceutical manufacturer offerings would be most compelling to commercial health plan decision-makers to support their oncology-related needs?

Key Finding: Insights and solutions for cost-effectively managing the cancer patient along the treatment journey is the primary unmet need of commercial health plans, and manufacturers' access point to drive collaborative opportunities.

Genentech is Most Often Nominated as the Commercial Health Plan "Partner of Choice" in Oncology. Genentech is the oncology partner of choice with the most nominations in 2016, followed by Bristol-Myers Squibb and Pfizer. The three leading manufacturers, in addition to AbbVie, have meaningfully increased in number of parther of choice nominations since 2015. 

Health plans' perspectives regarding their partner of choice selections reveal six factors that drive nominations, which range from the company's account management support and personnel to its willingness to contract. The complete listing of nominations and a detailed analysis of the factors driving panelists' selections is available in the full report.

Plans Perceive an Incremental Increase in Contract Availability for Oncology Medications. Panelists report that flat access rebates are the most common contract type offered for oncology medications. While the availability of contracts for oral and IV drugs remains relatively low overall, panelists perceive an incremental increase in contract availability across select contract types in the last year, most notably in two-year price protection and market share rebates. 

The full report provides a summary of perceived contract availability for oral and IV oncology medications, as well as change in availability year-over-year, for six contract types.

Numerous Partnership Opportunities Identified as Plans Look to Manage Costs and Enhance the Quality of Cancer Care. Commercial health plan pharmacy and medical directors were asked to consider and rate the relevance and availability of fifteen oncology-related manufacturer support offerings within the following categories: (1) General Account Support, (2) Educational Support, and (3) Adherence Support. Analyses of plans' most urgent need for a partner within each category reveal unmet needs related to managing the cancer patient in the most cost-effective manner. 

Analyses of partnership opportunities across the complete listing of fifteen manufacturer support offerings are available in the full report. 

Research Methodology and Report Availability. In February-March, HIRC surveyed 55 pharmacy and medical directors from national, regional, and blues plans representing 84 million lives. Online surveys and follow-up interviews were used to gather information. The full report, Commercial Health Plans: Manufacturer Competitive Assessment and Contracting for Oncology Medications, is part of the Managed Oncology Service, and is now available to subscribers at www.hirc.com/summary/mos.

 

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