What do employers look for to determine the value of best-in-class therapies?

“I don’t believe rebates should determine whether we cover a specific treatment – it should be efficacy. I reference randomized controlled trials, double-blinded and peer-reviewed studies that focus on efficacy when discussing plan design changes with my health plan and PBM.”

“With some of these game-changing therapies, we reach out to the manufacturer directly to better understand their data and evidence and how the science stacks up.”

“We talk with our health plans, PBMs, and consultants to understand how they have evaluated certain new-to-market drugs from a clinical standpoint. It all goes back to data and real-world evidence.”

“I look at what the prescribing community has to say, especially with new therapies. I am interested in what medical associations, large hospital groups, and prescribers are doing and value their perspective when a new therapy comes out.”