Telehealth From Home
November 1, 2018

Payers Seeking Support for Reimbursement

Payers seeking support for reimbursement decisions often turn to digital information sources.


Payers are almost equally as likely to get decision support from websites than from consulting with colleagues.

 

Healthcare payers in the U.S. are digitally savvy, and open to working with pharmaceutical companies to develop digital tools, finds a study into payer decision-making behaviors and preferences.

The survey is part of a series delivering primary research on payer behaviors and preferences to support effective interaction with the pharmaceutical industry.

Impact

The switch marks the beginning of a sea change among payers, as more switch to digital tools and methodologies for communicating with various entities.

What else you need to know?

Payers rely heavily on digital sources of information for formulary decisions, the findings show. On a weekly basis, they are as likely to visit websites for healthcare professionals — 63 percent do so — as they are to consult with colleagues for professional information (62 percent).

These payers express a strong preference for third-party websites, but visit pharmaceutical company websites frequently. One in three do so weekly.

Respondents also expressed skepticism of pharmaceutical company claims, although the study did find strong interest in partnering with drug makers on digital patient tools to reduce readmissions and produce better outcomes.

The trend.

Payers have been embracing digital tools more and more over the past few years. In May, regulatory changes from the Centers for Medicare and Medicaid Services allowed payers to send evidence of coverage information electronically for the first time, which could help them avoid up to $54 million a year in mailing costs.

On the record.

“We’re excited to share what we’ve learned about these key healthcare decision-makers in the U.S.,” said Heather Figlar, director of HCP and payer research at DRG Digital. “It really spotlights a need for pharmaceutical firms to take a much more multichannel approach to payer communication. This study provides evidence that dossiers should be merely the starting point for a cascade of digital communications across many channels and stakeholders.”

“The time pressure payers face is universal,” said Jeff Wray, director of Europe and APAC Research. “We find that while there are important idiosyncrasies to payer behaviour in each individual market, payers’ need to gather information as efficiently as possible is a constant, whether it is a P&T committee member at a Managed Care Organisation in Boston or a regional P&R decision-maker in Galicia.

“Companies must understand the where, what, and why of payers’ multichannel information-seeking behaviour to provide the most relevant and effective support.”

Their take.

The authors suggest this is a positive trend, perhaps helping to facilitate smoother interactions between payers and pharmaceutical companies in particular.

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