Rising healthcare expenses have insurance companies desperate to cut costs, and many worry this will prompt increasing restrictions across the board on patient prescription drug coverage. However, Putnam discovered 8 classes of drugs, accounting for over $100 billion in sales, where insurers believe that increasing the number of patients on therapies and getting those patients with prescriptions to take their drugs would create value for both patients and plans in the long term.
Plans' interest in seeing increased appropriate use suggests there is opportunity for pharmaceutical manufacturers to align with them on certain drug categories. "The common ground between health plans and pharmaceutical manufacturers is around appropriate use, as these conversations can unlock value and address needs for both parties," says Richard Tinsley, Partner at Putnam Associates. He adds, "Our study shows there is clear agreement and opportunity for expanded appropriate use in many categories while in others there is less agreement. One of the key challenges for a managed markets team is how to address these issues at a portfolio level."
Putnam Associates researchers spoke to health care plan decision-makers who collectively insure 62% of the privately insured U.S. population, or roughly 124 million individuals. Insurers were asked to consider both underuse and over use of branded prescription drugs across 18 drug categories. Of the 18 categories, 8 were identified as being underused.
To download a copy of "U.S. Managed Markets: Opportunities and Risks in the Emerging Appropriate Use Paradigm" visit http://www.putassoc.com/company/pub_usmanaged.html