Cost May Not Drive Formulary Choice After All

November/December 2010, Vol 3, No 6 - Conference Highlights AMCP

There may be discordance between what pharmacists say influences their formulary decision choices, and what actually influences those choices, according to an exploratory study examining the importance of product and manufacturer attributes.

Researchers from Mercer University College of Pharmacy and Health Sciences in Atlanta, GA, were interested in understanding how pharmacists’ perceptions of various product and manufacturer attributes impacted formulary decision­making. To do so, they conducted an online survey in January 2010 using a convenience sam­ple of 176 managed care pharmacists. Participants were asked to rate the importance of and performance of 14 product and manufacturer attributes, and were asked to make 2 hypothetical product choices in lipid­lowering agents and proton pump inhibitors (PPIs).

A total of 30 (17%) surveys were completed. Factors rated as high performance/high importance in formula­ry decision­making were related to product (ie, safety, efficacy, net ingredient cost, product superiority, and available outcomes data).

Factors given low performance/low importance were related to manufacturers (ie, size, customer programs, current market share, and ability to drive market share). If safety and efficacy were the same among products, 87% of respondents indicated that cost would be the final basis for their decision.

Costs were also professed as the decision­making basis for the hypothetical scenarios; however, an exam­ination of published formularies reveals that only 27% had the lowest cost PPI on formulary and only 7% had the lowest cost fibrate.

Despite rating net ingredient cost as important, “most plans do not have branded products with the lowest ingredient cost in preferred positions on the for­mulary,” the authors concluded.

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Last modified: December 23, 2010
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