Comparative-effectiveness research (CER) has been gaining ground as health plans seek to provide optimal patient care through evidence-based decisions. The federal government has recognized the importance of CER with the establishment of a national data clearinghouse and funding of other research activities, but it has not yet delivered the evidence that payers are seeking. As a result, insurers and PBMs are conducting their own real-world evidence studies to determine which drug therapies provide the best health outcomes and are the most cost efficient. Find out what innovative steps two industry leaders have taken to generate real-world data to develop better drugs and help payers make outcomes-based formulary decisions.
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More than half of the new drugs approved by the FDA during the past decade have been accompanied by some form of comparative-effectiveness data from clinical trials. But health plan experts often discount the study design, the lack of full category comparisons or the data’s ability to be applied to the real world and help payers determine which therapies deserve preferred status. While randomized controlled trials continue to be the gold standard, managed care experts are increasingly recognizing the value of supplemental real-world data in helping them to make formulary decisions. And although more than $1.1 billion in ARRA funds have been earmarked for CER and the health reform law established the Patient-Centered Outcomes Research Institute, plans can’t afford to wait for new data.
As a result, health plans and PBMs alike are teaming up with pharmaceutical companies to perform their own CER to determine the therapies in various categories that have the most value for payers. For example, HealthCore, Inc., the health outcomes research subsidiary of WellPoint, Inc., and AstraZeneca Pharmaceuticals LP have pooled their resources to conduct real-world studies aimed at determining how to most effectively and economically treat disease, with special emphasis on chronic illnesses. Unlike controlled clinical trials, real-world evidence studies use observational data such as electronic medical records, claims information and patient surveys.
Listen in as top executives from HealthCore and AstraZeneca demonstrate how these two companies have collaborated to deliver real-world evidence to payers. You’ll get insider perspectives on key questions such as:
MARCUS D. WILSON, Pharm.D., is president of HealthCore, WellPoint’s wholly owned outcomes research subsidiary. Dr. Wilson received his Bachelor of Science in Biochemistry from Virginia Tech and his Doctor of Pharmacy degree from the Medical College of Virginia. Dr. Wilson serves as a member of the FDA Mini-Sentinel Program’s Project Operations Council, the Brookings Active Safety Surveillance Council, the Observational Medical Outcomes Partnership Executive Board, the Board of Visitors for the Mayes College of Healthcare Business & Policy at the University of Sciences in Philadelphia and the 2020 Vision Task Force for the International Society of Pharmacoeconomics and Outcomes Research (ISPOR). He is a past member of the Board of Directors for ISPOR and is a reviewer for multiple journals.
BRIAN SWEET, B.S. Pharm., M.B.A., is executive director, healthcare alliances, at AstraZeneca. Mr. Sweet is focused on AstraZeneca’s initiatives in real-world evidence and comparative-effectiveness research and collaborating with health plans, pharmacy benefit managers and a variety of key business partners. In addition, he coordinates with managed markets customers on the development of performance-driven models, health improvement programs, value-based insurance designs and evolving health care reform issues. Mr. Sweet is the former chief pharmacy officer of WellPoint. He was responsible for overseeing all clinical pharmacy services at WellPoint including leading the National Pharmacy and Therapeutics Committee, which uses integrated data analyses and total cost of care modeling to improve patient health outcomes. In addition, he oversaw the development of strategic pharmacy alliances with academia, government, health organizations and pharmaceutical companies for the purpose of working together to promote the effective and appropriate use of drugs in the communities that WellPoint serves. Mr. Sweet provided strategic leadership for establishing enterprise pharmacy programs as an integral part of the organization in developing corporate pharmacy policy and innovative pharmacy benefit designs. He was also responsible for influencing public policy by communicating with media, analysts, professional organizations, members and providers to provide: public policy, legislative and media responses related to pharmacy coverage, benefits, medication management, the WellPoint Outcomes-Based Formulary application and specialty pharmacy initiatives.
Moderator: Lauren Flynn Kelly, editor of AIS's Drug Benefit News
Pharmacy, clinical services and medical directors; strategic planners; product development, contracting and marketing executives; and financial and operations executives at
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