Managed Markets

Clearly analyze managed care performance for your brands

Symphony Health’s Managed Markets Consulting Group offers a comprehensive collection of managed care solutions that leverage deep payer insights from the IDV (Integrated Dataverse). Using leading benchmarking analysis methods, we offer an array of key Managed Markets studies, subscription options, and reporting tools that will enable you to clearly analyze managed care performance and effectively partner with payers to positively impact prescription performance.

Data can be viewed by MCO/Plan, Geography or Client-Specific Sales Alignment to show you how benefit design is impacting product sales, providing visibility into the impact of payer rejections and patient reversals, as well as average patient pay amounts. Competitive comparisons are available to detail how other products in the market are impacted.

Studies and custom projects to strategically manage your health plan portfolio

Key Managed Markets Consulting projects include the following studies, however custom consulting projects utilizing IDV can be performed to answer any payer-driven business question. Within each core capability we offer specific studies that can address any pharmaceutical company’s payer related questions.

  • Payer Market Overview – Provides a general overview of a specific product or a therapeutic area access at a Channel or Payer/Plan level
    • Payer Landscape: A landscape analysis study is comprised of three reports profiling your product and competitors in the market. Plan Control Indices, which shows how payers compare and how benefit design impacts market opportunity. Payer Rejection Reasons provides visibility into which utilization management tools are being used to block access in the market. Finally, Plan Benefit Design shows how out of pocket cost sensitivity impacts patient reversals.
    • Primary Final Analysis: Increasing patient burden has been accompanied by increased utilization of copay offset programs such as payer rebates, and direct to consumer rebates/copay cards. Our Primary and Final Payer Analysis, leveraging exclusive payer focused data, provides you with enhanced primary and final payer visibility.
  • Evidence Based Formulary Control and Access – Analyzes a payer’s true span and depth of control for a product or a therapeutic area
    • True Benefit Design Analysis
    • Time To Fill Study
  • Payer Membership Trend – Analyzes how patients flow from payer to payer and how that impacts brand utilization
    • Patient Payer Switch Study
  • Payer Influence over Member Population – Analyzes how access and utilization patterns are driven by patient type
    • Medicare Part D study: Medicare Part D analysis leverages exclusive payer focused data, including patient level insights, to allow for accurate market assessments, providing leading coverage of Medicare Part D patients. Patient level analysis identifies the mix of patients based on Medicare eligibility type (e.g., Standard Eligible, Dual Eligible, and Low Income Subsidy). Medicare Part D Analysis also includes monthly analysis of where Standard Eligible patients are in the Medicare benefit cycle (e.g., receiving benefits, entering the coverage gap, exiting the coverage gap and entering the catastrophic coverage phase).
    • High Deductible Health Plan study – NEW OFFERING
  • Payer Control over Prescriber Prescribing Habits – Understand how payer control and physician payer mix ultimately drives access and long term utilization behavior for physicians and territories
    •  Physician Index Study
    •  Physician Adoption Study
  • Copay Card Monitoring and Optimization studies reveal the utilization of copay cards back to the patient’s prescription benefit provider, and evaluates the impact of existing and new programs to improve ROI, providing transactional level insight into the patient’s Primary Plan Pay, such as the initial co-pay amount. Final Plan Pay (copay card) provides insights into how much the brand is subsidizing the prescription.

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