US Payers: Comparative Effectiveness Research (CER) and Formulary Decision-making

Q1, 2012

It will come as no surprise that regulatory approval is no longer the only hurdle necessary to ensure commercial success. Today, and likely more so in the future, the real hurdles will come in receiving optimal reimbursement and market access.

The question that ISR poses: How will comparative effectiveness research (CER) affect P&T Committee’s reimbursement decisions?

This report was developed to answer that very question as well as some other very specific questions to US payers about comparative effectiveness research.

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  • 115Pages
  • 98Charts and Graphs
  • 30P&T Committee Members

Major Report Sections:

  1. CER Market Dynamics, including definition of CER, influence of CER, and issues with Randomized Controlled Trials (RCTs) and efficacy
  2. Drivers of Formulary Decision-making organized by study type and therapeutic areas

Study Types Analyzed for Influence on Formulary Decision-making:

  • RCTs
  • Health-economics Outcomes Research (HEOR)
  • Observational Studies
  • Meta-analysis

Cross-therapeutic Analyses:

  • Arthritis
  • Asthma
  • Diabetes
  • Heart Disease
  • Hypertension
  • Mental Health
  • Oncology

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