Some new product launches have been halted during the pandemic, and manufacturers haven’t been able to rely on their traditional promotional strategies. With sales teams unable to visit their customers in-person, many are adding more virtual selling to the mix.
For many organized providers across the country, value analysis and P&T committee meetings have been put on hold. Instead, the focus in recent weeks has been on managing a surge of COVID-19 patients and securing supplies to keep their staff safe. Meanwhile, many non-COVID patients have stayed away from healthcare providers and delayed getting necessary treatment, including new prescriptions, because of the crisis.
For your account teams, the disruption caused by COVID-19 could affect formulary reviews and present added market access challenges. At least one consultant, writing in Pharmacy Times, predicted that customers might be less likely to enter complex, risk-based contracts with manufacturers in the months ahead.
But in other ways, patient access to pharmaceuticals has eased as a result of the pandemic. To ensure their members have access to the drugs they need, health plans and pharmacy benefit managers (PBMs) have changed some of their utilization management policies.
According to the actuarial services firm Milliman, many PBMs have extended prior authorizations for previously approved prescriptions. In addition, several health plans are easing up on their early refill policies. Aetna is waiving early refill limits on 30-day prescription maintenance medications for members who receive their drugs through CVS Caremark.
Other payers are actively moving members to mail-order pharmacy services. Cigna is offering free home delivery of up to 90 days of prescription maintenance medications through Express Scripts Pharmacy.