<<” With this said, I believe this approach will have a high value with the healthcare reform that will take place.”>>
Yes it will indeed….Big time….Consider the following: Currently only about 25% of all private sector health plans are “managed care.” By contrast, 100% of gov’t plans are “managed care.” As the gov’t continues to exert pressure on the private sector to model their coverage in the gov’t image, more and more plans will convert to managed care beyond the simple and passive use of tiering to drive drug selection. For most of the population, a completely “Open” healthcare plan is going to be a thing of the past. As emphasis is placed on preventative care, I believe DSM will play an active and expanding role.
That being said…..it is still a gamble from the gov’t financing point of view. A few years back the gov’t, using flawed metrics, conducted a clinical trial on DSM. Their study concluded that DSM does NOT result in any healthcare savings. This despite numerous other studies concluding just the opposite and the sheer number of clients who can testify to the savings. The gov’t study did not require the patients in the study to be stable which is a mandatory metric for a successful DSM program and the duration of the trial was too short for any savings to be seen. Unfortunately, it was this gov’t study and only this study which was circulated to Congress during hearings on the DSM programs so the whole DSM ideology has been thrown up in the air. In the end though I think we will see DSM prevail as companies search for ways to lower their healthcare expenditures.
It depends on how you define managed care, most if not all heath plans have a specialty component that looks at the outliers.
As for generic vs name brand this is a section that will soon be exposed to a critical eye going forward. Not that the impact will move the needle much but it will be a factor in drug selection/negotiation.
As for the governments managed care programs they are not that advanced in understanding what cost/outcome objectives could be achieved with a seamless system with competition of course. And I agree with you on selection criteria it is not like when a new drug or product goes into clinical trials. I think you understand what I mean.
This is a open field in generating the cost/outcome that has yet to be integrated by CVS and walgreens. From a business perspective leverage is going to be a Key point in profitability from the data mining that will take place. I also don't disagree with you of where Walgreen's has lost a lot time. I am not even sure if they get it.. or the profit value of this.