2021 Managed Healthcare Executive Pharmacy Survey

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* 1. By what month will herd immunity against COVID-19 be achieved in the U.S. through vaccination and individuals having had the infection?

August

September

October

November

December

Not by the end of 2021

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* 2. Rate your level of concern about the current vaccines being insufficiently protective against the coronavirus variants?

Very Low

Somewhat low

Neutral

Somewhat high

High

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* 3. How many vaccines do you expect to be available in the U.S. by the end of the year?

More than 5

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* 4. When will children under age 12 be safely eligible to receive a COVID-9 vaccine?

End of Q2

End of Q3

End of 2021

Not this year

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* 5. How likely is it that COVID-19 vaccination will become an annual immunization?

Unlikely

Somewhat unlikely

Neutral

Likely

Very likely

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* 6. Rate the Biden administration’s response to pandemic.

Poor

Fair

Neutral

Good

Excellent

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* 7. What will be the most important, lasting effect of the COVID-19 pandemic on the U.S. healthcare system?

Increase in provider/hospital consolidation

Increase in telehealth

Increase in at-home care of all kinds

Increased attention on addressing inequities in healthcare

Increase in value-based payment and a decrease in fee for service

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* 8. What will be the most important, lasting effect of the COVID-19 pandemic on the pharmaceutical sector?

Increased use of mail-order pharmacy

Increase in the transition from hospital- and clinic-administered infusion to home infusion

Increase in research and development focused on infectious disease

Increase in the adoption of more restrictive and limited formulary/drug benefit offerings

Increase in use of pharma-funded patient assistance programs

Delays in the introduction of new drugs because of disruptions in clinical trials

Decrease in uptake of newly-approved therapies because of the disruption of traditional marketing and detailing activities

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* 9. What are the most effective ways to reduce traditional pharmaceutical costs? (Pick up to three.)

Enhanced point-of-prescribing tools to encourage use of most cost-effective medications

More aggressive and expansive utilization management strategies

Revised benefit design to create incentives for patients to choose low-cost options

Narrower, simpler formulary design with more exclusions

Expanded digital tools to promote lower-cost alternatives directly to patients

Improved price transparency

Lower out-of-pocket costs for high-value medications

Performance-based contracting between payers and prescribers to promote formulary compliance and generic drug prescribing

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* 10. What are the most effective ways to reduce specialty pharmaceutical costs? (Pick up to three.)

Performance-based (outcomes-based) contracting between payer and drug manufacturers

Performance-based contracting between payer and prescribers to promote compliance with clinical pathways

Medicare price negotiation

Formulary adoption and prescribing of biosimilars

Formulary structures and limits based on cost-effectiveness assessments by groups such as ICER

Mandated use of specialty pharmacy white-bagging to limit buy-and-bill incentives

Exclusive contracting with a single specialty pharmacy

Expanded tools/resources to manage infused specialty products under the medical and/or pharmacy benefit

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* 11. Which conditions will account for the strongest upward pressure on drug expenditures in 2021? (Pick up to three.)

Multiple sclerosis

Rheumatoid arthritis

Autoimmune disease other than multiple sclerosis and rheumatoid arthritis

COVID-19

Solid tumors

Hematological cancers

Diabetes

Heart disease

Migraine

Depression

HIV/AIDS

Anticoagulation

Rare/orphan diseases (collectively)

Other

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* 12. What will be the biggest driver of specialty drug expenditures in 2021?

Growing demand because of an aging population with multiple chronic conditions

Shift from traditional to specialty medications for treatment of common diseases

Orphan drug approvals by the FDA

Price increases by manufacturers

Limited number of biosimilars on the market

COVID-19 dynamics affecting specialty drug prescribing and patient utilization

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* 13. Which of the following are likely to be the most significant changes in contracts between plan sponsors and PBMs in the near future?

Greater emphasis on transparency

Increased demand for pass-through rebates and network pharmacy pricing

Decreased emphasis on rebate guarantees and a shift toward lowest net-cost formularies

Greater emphasis on financial penalties for operational execution

Greater emphasis on trend and cost-based guarantees and shared-savings contracts

Full-risk capitation

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* 14. Which drugs that have come on the market in the past 12 months hold the most promise for reducing morbidity and mortality?

Orgovyx (relugolix) for prostate cancer

Imcivree (setmelanotide) for rare forms of obesity

Oxlumo (lumasiran) for primary hyperoxaluria type 1

Zokinvy (lonafarnib) for rare conditions related to premature aging

Evrysdi (risdiplam) for spinal muscular atrophy

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* 15. Which drugs in the pipeline hold the most promise?

Farxiga (dapagliflozin) for chronic kidney disease in adults with or without type 2 diabetes (a new indication)

Roxadustat for anemia associated with chronic kidney disease

Teplizumab for prevention of type 1 diabetes

Valoctocogene roxaparvovec for severe hemophilia A

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* 16. Which of these federal policies do you favor as a way to curb drug prices?

Mandating transparency in coverage rules

Negotiating Medicare drug prices

Requiring PBMs to reimburse pharmacies at or above pharmacies’ drug acquisition costs

Restricting the use of copay accumulator programs

Putting limits on drug price increases

Putting limits on out-of-pocket costs for Medicare beneficiaries

Linking Medicare Part B drug prices to prices paid in other countries (the most-favored-nation model)

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* 17. Which of these federal policies do you think is most likely to occur in 2021?

CMS negotiating Medicare drug prices

Federal limits on drug price increase

Limits on out-of-pocket costs for Medicare beneficiaries

Most favored nation model for Medicare Part B drugs

None of the above

No substantial federal policy change will occur

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* 18. Please indicate your primary type of business

Healthcare provider (hospital/physician practice/clinic/integrated deliver)

Healthcare administrator or executive

Consultant/management service

Health plan/HMO/PPO

Pharmacy benefit manager

Employer group

Pharmaceutical company executive

Other

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* 19. Please add your contact information to be entered into a drawing for 1 of 4 $50 Visa gift card.

Name

State/Province

Country

Email Address