Though medical professionals continue to be the key decision-makers and influencers on drug formularies, hospitals executives are gaining in stature on these agreements, a new study has found.
Chapel Hill, N.C.-based Best Practices issued the report, titled “Sales Force Effectiveness: Benchmarking the Resources and Structure Required to Service the U.S. Hospital Marketplace,” primarily for pharmaceutical companies, but researchers say the findings are relevant for hospitals as well.
“Providers can utilize the information to let their staffs understand how they might be approached by sales reps in the future,” said lead researcher Cameron Tew. “It also provides hospitals with an idea of what employees or functional groups may need to train for in dealing with sales reps.”
Based on a survey of 22 executives from 17 pharmaceutical companies, the study identified medical professionals – including physicians, clinical pharmacists and therapeutic area specialists – as the most important class of decision-makers and influencers regarding formulary decisions, though “hospital executives’ influence has begun to rise,” the report stated.
“There has begun to be more emphasis placed on P & T (pharmacy and therapeutics) committees and chief medical officers as well as other hospital executives,” Tew said.
Key issues tied to formularies relate to adherence, compliance and drug efficacy. The study recommends that drug companies be prepared to discuss these topics when they meet with hospital administrators.
Fred Pane, senior director of pharmacy affairs for San Diego-based Premier, says that’s good advice.
“Formulary decisions are based on efficacy, safety and cost,” he said. “Hospitals must tie manufacturers into clinical outcomes, to ensure the drugs do what manufacturers say they will do. The best thing they can do if they get their drug on formulary is to ensure appropriate use and that hospitals achieve the outcomes they should be seeing with those products.”
To be sure, formularies have become more complex and variable, says Ken Lowrie, director of the pharmacy and professional services practice for the Chicago-based Huron Consulting Group. Moreover, the underpinnings of the agreements include the formal evaluation of clinical equivalency.
“We’re seeing more hospitals getting involved in comprehensively comparing the equivalency of comparative drugs,” he said. “That is very much factored into their thinking. We are consistently seeing P & T committees looking at efficacy first and for those equivalents, which ones have the best cost implications.”