Commercial Health Plans: Partner of Choice and Program Opportunities

Commercial Health Plans: Partner of Choice and Program Opportunities

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Understanding customers' needs and priorities is fundamental in maintaining partnerships as the health care landscape continues to evolve. HIRC's report, Commercial Health Plans: Contracting Landscape and Manufacturer Competitive Positioning, reviews payers' program needs, engagement with manufacturers, and identifies opportunities for partnership. The report addresses the following questions:

  • Which manufacturers are most often nominated as plans' overall "Partner of Choice"?
  • What factors drive overall "Partner of Choice" nominations?
  • Which therapeutic areas offer the most opportunity for program support?
  • What types of programs and resources are commercial plans' most interested in?
  • What program opportunities exist for manufacturers to distinguish themselves as valued partners?

Key Finding: Commercial payers identify programs that drive value through quality improvement and measurable outcomes as their most urgent need to partner with pharmaceutical manufacturers.

GlaxoSmithKline and Merck Receive the Most "Partner of Choice" Nominations. GlaxoSmithKline is most frequently nominated as the commercial health plan partner of choice, followed closely by Merck. The primary factors driving partner of choice nominations include the quality of a firm's programs and resources, understanding customers' business needs and bringing relevant resources, and being a strategic and flexible partner.

Support in Reducing Hospital Readmissions Continues to be an Unmet Customer Need. Commercial health plan respondents were asked to rate their interest and perceived manufacturer investment across twelve distinct program/resource areas. HIRC identified six program areas where payer interest and perceived manufacturer investment are not in alignment, with support in reducing hospital readmissions representing the largest gap. When considering engagement with payers, manufacturers must carefully craft programs that address challenges in quality and outcomes, medication adherence, and patient assistance.

Research Methodology and Report Availability. In December 2016 and January 2017, HIRC surveyed 66 commercial health plan pharmacy and medical directors from national, regional, and BCBS plans. Online surveys and follow-up telephone interviews were used to gather information. The complete report, Commercial Health Plans: Contracting Landscape and Manufacturer Competitive Positioning, is available now to HIRC’s Managed Markets subscribers at www.hirc.com.

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