Although news headlines in the past year have highlighted the aggressive stance of some pharmacy benefit managers (PBMs) in controlling access to drugs, the reality is that most such managers lack access to the basic data to support such stances. That's one of the results from a study conducted by Precision Advisors (Cambridge, MA), a consultancy that advises life sciences companies on how to interact with PBMs, health systems and other managed care organizations (MCOs). The survey, Digital and Data Trends in the Payer Marketplace, found, in late 2014, that only 46% of MCO executives have access to electronic health-record (EHR) data, which presumably would enable them to both manage the cost of therapies and verify how well formulary plans are being fulfilled. By 2016, 73% of execs expect to have this access, but "that looks optimistic," says Larry Blandford, managing director of the firm, citing the difficulties of pulling relevant data from EHR systems to support solid clinical decisions.
Other data desires: 21% of respondents seek access to lab data; and 47% want to make use of predictive analytics tools (rising to 80% by 2016).
Accountable care organizations and other value-for-performance structures in healthcare delivery make access to such data all the more important, says Blandford. He advises pharma firms to fill this information gap with appropriate data drawn from clinical and outcomes studies. (A surprising 45% of respondents agree that pharma "doesn't share data.")
The report is available for purchase from Precision Advisors.