First biosimilar marketing initiatives by MCOs in U.S. 2015

This survey depicts the initiatives managed care organizations (MCOs) are planning to undertake when the first biosimilar is marketed in the United States, as of 2015. The survey shows that 93 percent of MCOs plan to undergo a review by the pharmacy and therapeutics committee.

Planned initiatives of managed care organizations (MCOs) after first biosimilar is marketed in the United States as of 2015

InitiativePercentage of resondents
Undergo review by the Pharmacy & Therapeutics committee93%
Manage the use of the originator product via prior authorization (PA)48%
Manage the use of the biosimilar via PA44%
Add the product to formulary as preferred status42%
Institute a step-edit, establishing the biosimilar as first-line compared to the originator project38%
Add the product to appropriate standards of care (eg, guidelines, pathways)32%
Develop physician education materials about biosimilars28%
Develop member education materials about biosimilars24%
Set physician reimbursement lower than the originator product13%
Add the product to formulary as exclusive status, for aggressive contracting11%
Set physician reimbursement at parity with the originator product8%
Set physician reimbursement higher than the originator product7%
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Source

Release date

2016

Region

United States

Survey time period

June 29 to September 30, 2015

Number of respondents

100 managed care organizations (MCOs)

Method of interview

Online survey

Supplementary notes

The survey in total includes data from following groups: managed care organizations (MCOs), specialty pharmacies (SPs), oncologists, oncology practice managers (OPMs), employers that sponsor health benefits.

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