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Managed Markets Market Research:
        Effective Structures & Activities for
     Gaining Maximum Payer Access & Insight




                     Best Practices, LLC
                 Business Excellence Board
              Strategic Benchmarking Research
1
                    Copyright © Best Practices®, LLC   BEST PRACTICES,   ®
                                                                             LLC
Managed Markets Market Research:
Effective Structures & Activities for Gaining Maximum Payer Access & Insight

 Table of Contents

          Field Study Overview
          Key Findings
          Universe of Learning: Benchmark Class
          Structure Preferences
          Research Types That Deliver Greatest Insight
          Pre-Launch Objectives That Focus Research
          Innovative Practices for Developing Insights
          Timing of Key Managed Markets Market Research Activities
          Key Trends, Best Practices & Critical Pitfalls
          Appendix of Full Source Data & Analysis
  2
                               Copyright © Best Practices®, LLC   BEST PRACTICES,   ®
                                                                                        LLC
Research Objective
This client-driven research was conducted to help pharmaceutical and biotech companies
build effective Managed Markets market research functions that can drive access to—and
gain critical insights from—the increasingly influential Managed Markets sector.

      Study Objective & Methodology                                               Key Topic Areas
                                                                         Optimal structure and organizational fit
     Best Practices, LLC undertook this
                                                                         of the function responsible for Managed
     research to identify market research                                Markets market research (MMMR)
     activities and structures that are most
                                                                         Major pre-launch objectives for MMMR
     effective for gaining access to – and
     gathering insights from – the increasingly                          Top global Managed Markets research
     important Managed Markets sector.                                   activities by product development phase

     This research was completed using two                               Most effective activities for accessing
                                                                         hard-to-reach channel partners
     insight and intelligence gathering
     approaches: an online benchmarking                                  Primary categories of MMMR
     survey of Managed Markets executives at                             Most critical pre-launch study types
     leading pharmaceutical companies and in-
                                                                         Trends in MMMR staffing and focus
     depth field interviews with selected survey
     participants.                                                       Best practices and executive insights


3                                     Copyright © Best Practices®, LLC                            BEST PRACTICES,   ®
                                                                                                                        LLC
Definitions & Abbreviations
    The following definitions and abbreviations are used in this study:




           Definitions
      1.   Managed Markets: The function within pharma that is concerned with actions of
           payer (payor) organizations – including both commercial and government providers of
           prescription drug coverage (e.g., Medco, Cigna, United Healthcare, Medicare, Medicaid,
           Veterans Administration.)
      2.   Managed Markets market research (MMMR): The study of payer organization
           perspectives on topics such as meaningful endpoints, health outcomes, definition of
           innovative medical products, pricing requirements, formulary access/positioning,
           contracting, and reimbursement. Also includes research on payer companies and agencies
           and on current and future trends in the payer and managed care environment.
      3.   FTE: One FTE (full time equivalent employee) is the equivalent of one person working full
           time. Example: 2 people each working ½ time=1 FTE.

           Abbreviations
      •    MMMR=Managed Markets Market Research
      •    MM=Managed Markets
      •    MR=Market Research

4                                     Copyright © Best Practices®, LLC                  BEST PRACTICES,   ®
                                                                                                              LLC
Sample Key Findings
    The following key findings and insights emerged from the field surveys and
    executive interviews:


      Key Sources for Developing MM Insights: Ad boards and account managers
      (setting up team meetings) are the most effective MM activities and yield the best
      insights. Ad boards become most effective when innovative approaches are applied to
      engage diverse payer viewpoints instead of re-using the same small group of
      traditional payer participants.

      Role of Account Managers Is Expanding to Access MM Insight: Account
      managers’ roles are expanding due to the increase of Managed Markets influence in
      the pharmaceutical industry today. Account managers are seen by most participants
      as the most reliable method for accessing hard- to-reach partners. MM account
      managers play different valuable roles depending on the type of product, its market-
      entry order and its clinical profile.


5                                   Copyright © Best Practices®, LLC          BEST PRACTICES,   ®
                                                                                                    LLC
Universe of Learning: Participating Companies
Eleven leading pharmaceutical companies participated in this field research. Ten
organizations contributed to the performance benchmark survey, and six participated
through in-depth “lessons learned” interviews and discussions. Ninety-percent of
participants are at the director level or above.

         Participants in Survey Only
                Survey Only                                 Participants in Survey & Interviews
                                                                   Survey & Interview




                                                         Interview Only

    Participants’ Job Titles: EVP, Commercial Operations; VP, Managed Markets; Senior Director,
    Business Improvement; Executive Director, Managed Markets (2); Director, Managed Markets;
    Director of Marketing Research; Director of Strategy—Managed Markets; Associate Director of
    Managed Markets; Manager, Payer Analytics; and Director of Marketing—Managed Markets.

6                                 Copyright © Best Practices®, LLC                  BEST PRACTICES,   ®
                                                                                                          LLC
Ad Boards & Team Meetings Have Greatest Decision Impact
Six out of ten participating companies rank payer advisory boards and use of a team
approach to account meetings as the global MMMR activities with the highest impact
on strategic choices or decisions.

      Q. Which of the following global activities have the greatest impact on strategic choices?
                                                 % Very High Impact
                                                  (Rated "6" or "7")


                               Payer advisory boards                                                    60%

         Team approach to critical account meetings                                                     60%

                                   Market research                                               50%

                                                               `                          40%
         Health outcomes/economics data collection

                Field interviews with individual payers                           30%

          Interviews with internal account managers                        20%

       Managed markets industry meetings & events                   10%                % Responses

                                                          0%       10%    20%    30%    40%     50%    60%    70%

       (n=10)                                      Ranking Scale: 1=No impact to 7=Very high impact

7                                       Copyright © Best Practices®, LLC                               BEST PRACTICES,   ®
                                                                                                                             LLC
Payer Advisory Board Success Strategies
    Payer advisory boards are a high-impact, high-value activity for capturing Managed
    Markets insights – in part because companies have developed strategies to
    overcome limitations of this vehicle.

     Payer advisory boards can be highly effective for gathering Managed Markets insights if
     companies use innovative strategies to overcome some inherent limitations.
      Limitations:
        The same few people are on the boards every time
        There is insufficient diversity among board members
        Some important payers strictly prohibit participation
        because of compliance issues

      Strategies:
      Target a wider range of people within a payer company: “Most of the time we're all recruiting the vice-president of
      pharmacy or director of pharmacy. Look to people who are in charge of putting together dossiers. Who are those
      people and what is the information they look at when they're putting together a package for the P&T committee?
      Find medical directors working on a tech assessment that you should be targeting, because they're going to give
      you a very different perspective than are pharmacy directors. Pharmacy directors are thinking about placement on
      the formulary of a class of drugs and how you compete in that class of drugs. Medical directors will be thinking
      about what's medically necessary and what's not medically necessary.”                 – Interviewed Executive

      Reduce the size and change the name: “The big ad boards tend not to give you quality. One or two dynamic people
      often dominate and shut down the conversation. A group of four or five maximum gives us far better dialog. We don’t
      call them ad boards either—they’re focus groups now. We have had better success with smaller groups, not any
      different than getting a small group of physicians together at a society meeting—to give feedback. “ – Interviewed VP


8                                           Copyright © Best Practices®, LLC                            BEST PRACTICES,       ®
                                                                                                                                  LLC
Managed Markets MR Activities Peak During Phase 3
Phase 3 is the peak time for most global activities in Managed Markets market research,
although some companies begin selected activities as early as the Pre-Clinical stage of
product development. Earlier payer activities are a growing trend.
                Q. During which product development phase does the Managed Markets MR staff perform each activity?

                    100%                                                                    Field interviews with
                                                                                            individual payers

                                                                                            Health outcomes/economics
                    80%                                                                     data collection

                                                                                            Interviews with internal
                    60%                                                                     account managers
      % companies




                                                                                            Managed markets industry
                                                                                            meetings & events
                    40%

                                                                                            Market research

                    20%
                                                                                            Payer advisory boards

                     0%
                            Pre -     Phase 1     Phase 2        Phase 3           Launch   Team approach to critical
    (n=8-10)               Clinical                                                         account meetings


9                                               Copyright © Best Practices®, LLC                    BEST PRACTICES,     ®
                                                                                                                            LLC
Sample Best Practices: Structure & Communication
Benchmarked companies shared some of their best practices for Managed Markets
market research activities.



                               Structure/ Internal Communication

        Segment customer groups so that answers are more meaningful based on segment

        Keep management informed on challenges payers face. (“The more you can give senior
       management insight into the legitimate challenges that managed care plans face as they

         try to balance their cost picture, the better off you are. Communicate this right down to
       the rep level.”)

        Hire staff who have worked in the Managed Markets sector.

        Develop internal and external networks of MM experts.

        Align with internal government affairs group to be alerted
       to and to help shape future policy.

        Take brand team members to payer meetings.


10                               Copyright © Best Practices®, LLC                BEST PRACTICES,     ®
                                                                                                         LLC
About This Research




11
           Copyright © Best Practices®, LLC   BEST PRACTICES,   ®
                                                                    LLC
About This Research

 This presentation is the result of primary client-driven research conducted by Best
 Practices, LLC. See www.best-in-class.com for more on our research services.



 This benchmarking study is intended to be a directional indicator
 on the Managed Markets market research function.

 Clients have used our benchmark research in the following ways:
     •   Gap Analyses: Identify areas for improvement.
     •   Business Cases: Prepare a proposal for change.
     •   Training: Learn about new areas, industry trends & standards.
     •   Resourcing Decisions: Assess staffing, budget & structure.
     •   Sharing Research: Satisfy internal customers with unique data.



12                            Copyright © Best Practices®, LLC         BEST PRACTICES,   ®
                                                                                             LLC
Serving your Research Needs

If you want to visually compare your data with that of this study’s benchmark class, get
more research on this topic, or you want to sponsor a study, see below.


1) Customize this Presentation: We can chart and present your
  organization’s metrics in comparison to this study’s benchmark class.

2) Access more Client-initiated Research: If you purchased this study,
  you may be eligible for a credit toward membership. To learn what you
  can access, do an advanced search at www.bestpracticedatabase.com.

3) Conduct your Own Study: Let our analysts assist you in designing
  your own questions for an on-line survey and/or interview.
  www3.best-in-class.com/ResearchConsulting

                          Best Practices, LLC
               919-403-0251 ● bestpractices@best-in-class.com

13                             Copyright © Best Practices®, LLC         BEST PRACTICES,    ®
                                                                                               LLC
About Best Practices, LLC



 Best Practices, LLC is a research and consulting firm that conducts work based on
 the simple yet profound principle that organizations can chart a course to superior
 economic performance by studying the best business practices, operating tactics
 and winning strategies of world-class companies.

 Best Practices, LLC research provides key directional indicators, proven business
 practices and executive insights to support organizations seeking to achieve best-
 in-class business performance.




                       Best Practices, LLC
                        6350 Quadrangle Drive, Suite 200
                              Chapel Hill, NC 27517
                                 (919) 403-0251
                        bestpractices@best-in-class.com
                             www.best-in-class.com
14                           Copyright © Best Practices®, LLC         BEST PRACTICES,   ®
                                                                                            LLC

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Managed Markets Market Research- Payer Access & Insight Report Summary

  • 1. Managed Markets Market Research: Effective Structures & Activities for Gaining Maximum Payer Access & Insight Best Practices, LLC Business Excellence Board Strategic Benchmarking Research 1 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 2. Managed Markets Market Research: Effective Structures & Activities for Gaining Maximum Payer Access & Insight Table of Contents Field Study Overview Key Findings Universe of Learning: Benchmark Class Structure Preferences Research Types That Deliver Greatest Insight Pre-Launch Objectives That Focus Research Innovative Practices for Developing Insights Timing of Key Managed Markets Market Research Activities Key Trends, Best Practices & Critical Pitfalls Appendix of Full Source Data & Analysis 2 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 3. Research Objective This client-driven research was conducted to help pharmaceutical and biotech companies build effective Managed Markets market research functions that can drive access to—and gain critical insights from—the increasingly influential Managed Markets sector. Study Objective & Methodology Key Topic Areas Optimal structure and organizational fit Best Practices, LLC undertook this of the function responsible for Managed research to identify market research Markets market research (MMMR) activities and structures that are most Major pre-launch objectives for MMMR effective for gaining access to – and gathering insights from – the increasingly Top global Managed Markets research important Managed Markets sector. activities by product development phase This research was completed using two Most effective activities for accessing hard-to-reach channel partners insight and intelligence gathering approaches: an online benchmarking Primary categories of MMMR survey of Managed Markets executives at Most critical pre-launch study types leading pharmaceutical companies and in- Trends in MMMR staffing and focus depth field interviews with selected survey participants. Best practices and executive insights 3 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 4. Definitions & Abbreviations The following definitions and abbreviations are used in this study: Definitions 1. Managed Markets: The function within pharma that is concerned with actions of payer (payor) organizations – including both commercial and government providers of prescription drug coverage (e.g., Medco, Cigna, United Healthcare, Medicare, Medicaid, Veterans Administration.) 2. Managed Markets market research (MMMR): The study of payer organization perspectives on topics such as meaningful endpoints, health outcomes, definition of innovative medical products, pricing requirements, formulary access/positioning, contracting, and reimbursement. Also includes research on payer companies and agencies and on current and future trends in the payer and managed care environment. 3. FTE: One FTE (full time equivalent employee) is the equivalent of one person working full time. Example: 2 people each working ½ time=1 FTE. Abbreviations • MMMR=Managed Markets Market Research • MM=Managed Markets • MR=Market Research 4 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 5. Sample Key Findings The following key findings and insights emerged from the field surveys and executive interviews: Key Sources for Developing MM Insights: Ad boards and account managers (setting up team meetings) are the most effective MM activities and yield the best insights. Ad boards become most effective when innovative approaches are applied to engage diverse payer viewpoints instead of re-using the same small group of traditional payer participants. Role of Account Managers Is Expanding to Access MM Insight: Account managers’ roles are expanding due to the increase of Managed Markets influence in the pharmaceutical industry today. Account managers are seen by most participants as the most reliable method for accessing hard- to-reach partners. MM account managers play different valuable roles depending on the type of product, its market- entry order and its clinical profile. 5 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 6. Universe of Learning: Participating Companies Eleven leading pharmaceutical companies participated in this field research. Ten organizations contributed to the performance benchmark survey, and six participated through in-depth “lessons learned” interviews and discussions. Ninety-percent of participants are at the director level or above. Participants in Survey Only Survey Only Participants in Survey & Interviews Survey & Interview Interview Only Participants’ Job Titles: EVP, Commercial Operations; VP, Managed Markets; Senior Director, Business Improvement; Executive Director, Managed Markets (2); Director, Managed Markets; Director of Marketing Research; Director of Strategy—Managed Markets; Associate Director of Managed Markets; Manager, Payer Analytics; and Director of Marketing—Managed Markets. 6 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 7. Ad Boards & Team Meetings Have Greatest Decision Impact Six out of ten participating companies rank payer advisory boards and use of a team approach to account meetings as the global MMMR activities with the highest impact on strategic choices or decisions. Q. Which of the following global activities have the greatest impact on strategic choices? % Very High Impact (Rated "6" or "7") Payer advisory boards 60% Team approach to critical account meetings 60% Market research 50% ` 40% Health outcomes/economics data collection Field interviews with individual payers 30% Interviews with internal account managers 20% Managed markets industry meetings & events 10% % Responses 0% 10% 20% 30% 40% 50% 60% 70% (n=10) Ranking Scale: 1=No impact to 7=Very high impact 7 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 8. Payer Advisory Board Success Strategies Payer advisory boards are a high-impact, high-value activity for capturing Managed Markets insights – in part because companies have developed strategies to overcome limitations of this vehicle. Payer advisory boards can be highly effective for gathering Managed Markets insights if companies use innovative strategies to overcome some inherent limitations. Limitations: The same few people are on the boards every time There is insufficient diversity among board members Some important payers strictly prohibit participation because of compliance issues Strategies: Target a wider range of people within a payer company: “Most of the time we're all recruiting the vice-president of pharmacy or director of pharmacy. Look to people who are in charge of putting together dossiers. Who are those people and what is the information they look at when they're putting together a package for the P&T committee? Find medical directors working on a tech assessment that you should be targeting, because they're going to give you a very different perspective than are pharmacy directors. Pharmacy directors are thinking about placement on the formulary of a class of drugs and how you compete in that class of drugs. Medical directors will be thinking about what's medically necessary and what's not medically necessary.” – Interviewed Executive Reduce the size and change the name: “The big ad boards tend not to give you quality. One or two dynamic people often dominate and shut down the conversation. A group of four or five maximum gives us far better dialog. We don’t call them ad boards either—they’re focus groups now. We have had better success with smaller groups, not any different than getting a small group of physicians together at a society meeting—to give feedback. “ – Interviewed VP 8 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 9. Managed Markets MR Activities Peak During Phase 3 Phase 3 is the peak time for most global activities in Managed Markets market research, although some companies begin selected activities as early as the Pre-Clinical stage of product development. Earlier payer activities are a growing trend. Q. During which product development phase does the Managed Markets MR staff perform each activity? 100% Field interviews with individual payers Health outcomes/economics 80% data collection Interviews with internal 60% account managers % companies Managed markets industry meetings & events 40% Market research 20% Payer advisory boards 0% Pre - Phase 1 Phase 2 Phase 3 Launch Team approach to critical (n=8-10) Clinical account meetings 9 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 10. Sample Best Practices: Structure & Communication Benchmarked companies shared some of their best practices for Managed Markets market research activities. Structure/ Internal Communication Segment customer groups so that answers are more meaningful based on segment Keep management informed on challenges payers face. (“The more you can give senior management insight into the legitimate challenges that managed care plans face as they try to balance their cost picture, the better off you are. Communicate this right down to the rep level.”) Hire staff who have worked in the Managed Markets sector. Develop internal and external networks of MM experts. Align with internal government affairs group to be alerted to and to help shape future policy. Take brand team members to payer meetings. 10 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 11. About This Research 11 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 12. About This Research This presentation is the result of primary client-driven research conducted by Best Practices, LLC. See www.best-in-class.com for more on our research services. This benchmarking study is intended to be a directional indicator on the Managed Markets market research function. Clients have used our benchmark research in the following ways: • Gap Analyses: Identify areas for improvement. • Business Cases: Prepare a proposal for change. • Training: Learn about new areas, industry trends & standards. • Resourcing Decisions: Assess staffing, budget & structure. • Sharing Research: Satisfy internal customers with unique data. 12 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 13. Serving your Research Needs If you want to visually compare your data with that of this study’s benchmark class, get more research on this topic, or you want to sponsor a study, see below. 1) Customize this Presentation: We can chart and present your organization’s metrics in comparison to this study’s benchmark class. 2) Access more Client-initiated Research: If you purchased this study, you may be eligible for a credit toward membership. To learn what you can access, do an advanced search at www.bestpracticedatabase.com. 3) Conduct your Own Study: Let our analysts assist you in designing your own questions for an on-line survey and/or interview. www3.best-in-class.com/ResearchConsulting Best Practices, LLC 919-403-0251 ● bestpractices@best-in-class.com 13 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC
  • 14. About Best Practices, LLC Best Practices, LLC is a research and consulting firm that conducts work based on the simple yet profound principle that organizations can chart a course to superior economic performance by studying the best business practices, operating tactics and winning strategies of world-class companies. Best Practices, LLC research provides key directional indicators, proven business practices and executive insights to support organizations seeking to achieve best- in-class business performance. Best Practices, LLC 6350 Quadrangle Drive, Suite 200 Chapel Hill, NC 27517 (919) 403-0251 bestpractices@best-in-class.com www.best-in-class.com 14 Copyright © Best Practices®, LLC BEST PRACTICES, ® LLC