What Oncology Sales Reps Must Know

Prior authorizations, tiered formularies, formulary exclusions, step edits, and quantity limits are just a few of the utilization management strategies that payers rely on to control their drug spend. And while these tactics are designed to combat inappropriate use of expensive specialty drugs, they also can restrict patient access to life-saving oncology treatment.

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Utilization Management Tactics, Explained

Training on the most common utilization management strategies in oncology can help your sales teams hone their oncology business acumen and uncover new opportunities to enhance or protect their brand’s access. With these important targets in mind, we have developed a set of easy-to-follow summaries on payers’ utilization management strategies. This includes real-world tactics such as:

  • Requiring prior authorizations
  • Implementing step edits, or “fail-first” policies
  • Increasing patient cost-sharing and using tiered formularies
  • Managing to FDA labeling
  • Setting quantity limits
  • Excluding drugs from the formulary
  • Optimizing site of care
  • Using case management

Each summary provides a brief overview of the utilization management strategy and describes how it works in the oncology space. The summaries also explain how these practices affect different stakeholders, including physicians, specialty pharmacies, health plans, patients, and manufacturers. What’s more, each summary includes content designed to help oncology sales reps and account directors explore ways to improve access for their products.

Oncology Business Acumen Training on UM and More

Do your sales reps and account directors understand the various utilization management strategies that payers use in their category? If not, we can help. At CMR Institute, we can enhance your oncology business acumen curriculum with off-the-shelf, oncology sales training resources. This includes our utilization management summaries as well as a new resource on the Impact of COVID-19 on your oncology customers. We also have a new suite of sales training resources on oncology clinical pathways.

Contact us at (800) 328-2615 or at solutions@cmrinstitute.org so we can help your oncology sales team navigate these utilization management strategies and improve their sales performance.

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