Insurance and Benefit Design: Commercial

Insurance and Benefit Design: Commercial provides insights on the evolution of insurance and benefit designs in the commercial health plan channel, supporting timely, effective responses to emerging access opportunities and risks for brands.

  • What are the current and emerging trends in commercial plan benefit designs and drug management?

Use Insurance and Benefit Design: Commercial to:

  • Stay up-to-date on benefit design and pharmacy management trends, and anticipate emerging changes
  • Educate account teams and internal colleagues on changes that affect access
  • Pharmacy Coverage Landscape January
    • Overview of pharmacy coverage in the U.S.
    • Formulary control in the commercial channel
    • Emergence of specialty drugs, and common tactics for managing these products
  • Benefit Design & Pharmacy Management Trends February
    • Enhanced and restrictive benefits in commercial channel
    • Trends in premium costs, along with coinsurance, copay, and deductible amounts
    • Use of formulary exclusions and other utilization management tactics
    • Implementation of preferred distribution channels and shifts in site of care
  • Drug Management Tactics April, July, September
    • Profiles of 30 drug markets
    • Current and future management priorities, intensity, and tactics by market
  • Employer Coverage Decisions May
    • Health plan/PBM role and in uence in employer benefit and coverage decisions
    • Employer benefit consultant role in employer decisions
    • Strategies for direct-to-employer engagement
  • Payer Implementation of Copay Accumulator Programs June
    • Copay accumulator program prevalence and impact on patients
    • Biopharmaceutical company responses, including patient copay assistance
  • Patient Affordability Support August
    • Payer adoption of company financial support programs for patients
    • Provider and patient perceptions re ecting real-world experience
    • Best practices and recommendations
  • Management of Drugs with Medical Benefit Coverage August
    • Growth of cost-sharing requirements
    • Trends in SP use, buy-and-bill approval rates, and site-of-care selection
  • Coverage and Management of Biosimilars October
    • Comparison of U.S. and global markets
    • Payer coverage decisions, formulary placement, and utilization management tactics
    • Changes in company and payer contracting leverage
  • Consumer Decisions and Out-of-Pocket Costs November
    • Enrollment in CDHPs, HDHPs, HSAs, FSAs
    • Response to out-of-pocket costs, utilization management tactics
    • Awareness of bene t designs
    • Use of biopharmaceutical company programs
This product may also include relevant market alerts, real-time assessments of recent changes, or market events. EVERSANA reserves the right to change the timing and/or topics of its syndicated research publications.

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