Findings from University of Utah Provides New Data about Managed Care (Payer Perceptions On the Use of Patient-reported Outcomes In Oncology Decision Making): Managed Care

2022 MAR 29 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Managed Care. According to news reporting from Salt Lake City, Utah, by NewsRx journalists, research stated, “In oncology, especially with accelerated regulatory approvals and niche populations, US payers appreciate all evidence that can help support formulary decision making, including evidence beyond traditional safety and efficacy data from clinical trials. Research suggests payers incorporate patient-reported outcome (PRO) evidence in their decision making and expect the importance of PRO evidence to grow.”

Financial support for this research came from Pfizer.

The news correspondents obtained a quote from the research from the University of Utah, “Greater understanding on payers’ use of PRO information in oncology is needed. To assess US payer perceptions regarding the use of PRO evidence in informing oncology formulary decision making. A multidisciplinary steering committee involving a measurement specialist, health economics and outcomes research experts, and payers developed a survey containing single-answer, multiple-answer, and free-response questions. The pilot survey was tested at a mini-advisory board with 5 US payers and revised based on feedback. In February 2020, the survey was distributed to 221 US payers through the AMCP Market Insights program and 10 additional payer panelists who were invited to discuss and contextualize the survey results. Results were presented primarily as frequencies of responses and evaluated by plan size, type of health plan, and geography (regional vs national). Differences in categorical data responses were compared using Pearson chi-square or Fisher exact tests. Two-tailed values are reported and a P value less than or equal to 0.05 was used to indicate statistical significance. Overall, 106 of 231 payers (45.9%) completed the survey; 45.5% represented small plans (<1 million lives), and 54.5% represented large plans (>= 1 million lives). Respondents were largely pharmacists (89.9%), with 55.6% of all respondents indicating their job was pharmacy administrator. The majority of payers (60.0% of small health plans and 57.8% of large plans) felt PRO evidence from clinical trials is useful. Similarly, the majority of payers (57.8% of small plans and 51.9% of large plans) felt PRO evidence from real-world studies is useful. Almost half (47.1%) suggested formulary review would be influenced by a lack of PRO evidence from oncology clinical trials either somewhat, much, or a great deal. Most payers (78.2%) thought PRO evidence is useful for providing additional context for safety of oncology therapies. More than one-third of payers (34.3%) valued PRO evidence when comparing 2 similar therapies, and 51.5% felt PRO evidence may help in measuring value for value-based agreements. Panelists indicated PRO evidence can be useful for developing treatment pathways for addressing health-related quality of life, informing provider-patient dialogues, and defining progression-free survival length and quality. US payers view PRO evidence from both clinical trials and real-world studies as useful for supplementing traditional clinical trial data when making oncology formulary decisions and for refining treatment pathways and care delivery models.”

According to the news reporters, the research concluded: “Manufacturers of oncology therapies should collect and consider leveraging PRO evidence from both settings when engaging with US payers.”

This research has been peer-reviewed.

For more information on this research see: Payer Perceptions On the Use of Patient-reported Outcomes In Oncology Decision Making. Journal of Managed Care & Specialty Pharmacy, 2022;28(2):188-195. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

Our news journalists report that additional information may be obtained by contacting Diana Brixner, University of Utah, College of Pharmacy, Salt Lake City, UT 84112, United States. Additional authors for this research include Gary Oderda, Joseph Biskupiak, Douglas Burgoyne, Bhakti Arondekar, Linda S. Deal, Ruben Gw Quek and Alexander Niyazov.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.18553/jmcp.2021.21223. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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