Announcing OTCs Drugs in Managed Care: Taking the Pulse of MCOs and PBMs. This report will provide a detailed independent appraisal of complex issues related to promotion and coverage of OTC drugs in U.S. in the managed care setting. Research will be conducted by Kline’s analysts with executives at MCOs, PBMs, self-insured employer groups, OTC companies, public health advocates, attorneys, and consultants.

1. Healthcare
3rd Edition
OTC Drugs in Managed Care:
Taking the Pulse of MCOs and PBMs
To Be Published 2nd Quarter 2014
Base Year: 2013
Regional Coverage: United States
This report will provide objective insights on complex issues surrounding promotion of OTCs among
managed care organizations (MCOs) and pharmacy benefit managers (PBMs) including how these
groups handle Rx-to-OTC switch brands, strategies for successful partnering between OTC companies
and MCOs/PBMs, OTC promotion programs among MCOs/PBMs, and impacts of the Affordable Care Act
on these plans and OTCs going forward.
This Report Will Help Subscribers to:
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Understand MCO’s/PBM’s perspective on
OTCs and Rx-to-OTC switches
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Learn about successful OTC/managed care
promotional programs for OTC brands and
potential pitfalls of such programs
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Benchmark OTC companies can use to
evaluate their current approach with
managed care against that of their
competitors
www.KlineGroup.com
Report #Y575A | © 2013 Kline & Company, Inc.
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Gauge the impact managed care plans can
have on OTCs, such as potential coverage
for OTC brands, use of tiered copayments,
coupons for OTC purchases, or use of FSAs
to pay for OTCs
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Help facilitate dialogue between your
company and MCOs/PBMs

2. Healthcare
OTC Drugs in Managed Care:
Taking the Pulse of MCOs and PBMs
Tentative Report Contents*
Introduction
Promotional Programs
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Executive Summary
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An Overview of key findings
Forecasts and assessments
Managed Care Overview
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Background on managed care environment
Membership estimates for MCOs and PBMs
Estimates on self-insured employers
Rising costs of drugs for MCOs, PBMs, and selfinsured plans
Impacts of Affordable Care Act on managed
care plans and OTCs
Key companies
Rx-to-OTC Switches
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Changing Rx-to-OTC switch landscape
Categories MCOs/PBMs view as potential switch
candidates
NSURE and FDA initiatives
Programs that promote Rx-to-OTC switch
brands in managed care settings
www.KlineGroup.com
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Free-standing programs initiated by managed
care plans
Programs conducted in collaboration with OTC
marketers
Successful programs
Pitfalls of such programs
Perception of OTCs among MCOs and PBMs
Strategies OTC companies can adopt to create
win-win situations
Variables to measure relative success or failure
of such programs
Coverage of OTC Drugs
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Issues to consider
Formulary issues and tiered copayments
Member incentives
Reduction in prescription drug utilization
Levels of OTC coverage
* Subject to charter subscriber input
Report #Y575A | © 2013 Kline & Company, Inc.

3. Healthcare
OTC Drugs in Managed Care:
Taking the Pulse of MCOs and PBMs
Scope
OTCs Drugs in Managed Care: Taking the Pulse of MCOs and PBMs will provide a detailed
independent appraisal of complex issues related to promotion and coverage of OTC drugs
in U.S. in the managed care setting. Research will be conducted by Kline’s analysts with
executives at MCOs, PBMs, self-insured employer groups, OTC companies, public health
advocates, attorneys, and consultants. From these interviews, we aim to provide:
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MCO’s/PBM’s perspective on OTCs and Rx-toOTC switches
n
Details about successful OTC/managed care
promotional programs for OTC brands and
potential pitfalls of such program
n
Analysis of the impact managed care plans can
have on OTCs such as potential coverage for OTC
brands, use of tiered copayments, coupons for
OTC purchases, or use of FSAs to pay for OTCs
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Strategies for successful partnering with MCOs
and PBMs in the future
Key Benefits
This report will assist OTC companies in identifying opportunities to promote their brands
in the managed care setting. It will also serve as an invaluable tool in the strategic planning
process.
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Develop smart business strategies by
understanding the trends and developments that
are driving OTC/managed care partnerships
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Benchmark your organization’s programs in
managed care with those of your competitors
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Facilitate discussions between your organization
and MCOs and PBMs
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Capitalize on learning about pitfalls that may have
happened in the past and how to avoid them
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Ability to be dynamic and responsive to managed
care groups by identifying trends expected to
drive future trends and how these partnerships
may evolve in the future
Identify key managed care companies that may be
most receptive to promotional programs for your
OTC brands
www.KlineGroup.com
Report #Y575A | © 2013 Kline & Company, Inc.

4. Healthcare
OTC Drugs in Managed Care:
Taking the Pulse of MCOs and PBMs
Methodology
Kline’s approach places principal emphasis on primary research techniques to ensure that the foundation of
business intelligence and insight is accurate, current, and reliable. Building on our 50-plus years in the business
and leveraging our worldwide network of offices, our teams of seasoned professionals draw upon pragmatic
industrial and commercial experience to understand and interpret global impacts and local perspectives.
Primary Research
We Know Who to Talk to. We Know How to Listen.
A high number of in-depth discussions are conducted
by each analyst. All interviews are done with true
industry insiders.
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Managed care organizations (MCOs)
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Pharmacy benefit managers (PBMs)
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Self-insured employer groups
Our interviews engage experts across all pertinent
fields and sectors including:
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OTC companies
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Regulatory agencies
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Public health advocates
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Attorneys and consultants
Secondary Research
We Know Where to Look – Mining the Details.
Analysis is further supplemented by secondary
research, consisting of constant tracking of annual
company reports, national statistics bureaus, trade/
industrial/professional associations, and the like.
Relevant developments are diligently followed and
their impact closely monitored. Reports also draw
upon non-confidential data from Kline’s internal
database, consisting of over half a century’s syndicated research.
Comprehensive Market Intelligence
We Know How to Verify.
Data are rigorously analyzed, cross-checked, distilled,
and validated. Kline’s proven methodology allows
exceptionally effective, precise, and reliable market
intelligence procurement and assessment, giving
subscribers a solid foundation on which to grow,
refine, and expand their business with confidence.
Kline Credentials
A FULL SPECTRUM OF SERVICES
Kline is a leading global management consulting and
market research firm offering the complete spectrum of
services. The firm has served the management consulting and market research needs of organizations in the
chemicals, materials, energy, life sciences, and consumer products industries for over 50 years.
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Report #Y575A | © 2013 Kline & Company, Inc.