Chapter 10 - Managed Markets
Managed markets, he's our man, if he can't do it, no one can!
- 1.What are managed market customers?
- A.
Entities that play a large role in drug reimbursement
- B.
Large entities that have the power to affect utilization of drugs
- C.
Entities that determine drug reimbursement procedures
- D.
A and B
- E.
B and C
- 2.What are the two categories of managed markets?
- A.
Public and Government
- B.
Government and Commercial
- C.
Commercial and Private
- D.
None of the above
- 3.What role does Managed Markets play internally in a biotech/pharma company?
- A.
Financial analysis and valuation
- B.
Promotion and message platform as it relates to newly launched and approved drugs
- C.
Developing corporate strategies to lead the discovery team
- D.
Develop and execute strategies to secure access/reimbursement for company products
- 4.Which managed market channels are responsible for the vast majority of drug expenditures in the US?
- A.
Department of Veterans Affairs
- B.
Department of Defense
- C.
Medicare
- D.
Medicaid
- E.
All of the above
- 5.Select the best example of how managed markets wield their power indirectly:
- A.
They purchase drugs
- B.
They assign higher co-payments to disfavored products
- C.
They utilize restrictions that make it difficult to purchase certain drugs
- D.
A and C
- E.
B and C
- 6.What is the dominant US managed market segment?
- A.
Commercial managed care
- B.
Medicaid
- C.
Medicare
- D.
Dept of Veterans Affairs
- E.
None of the above
- 7.How does a major managed care plan steer prescribers away from disfavored drugs?
- A.
Higher co-pays
- B.
Require pre-authorization
- C.
Assign it to tier 1 on a formulary
- D.
A and B
- E.
All of the above
- 8.Why are physicians likely to make bright line decisions?
- A.
To get into a routine in order to avoid potential prescription hassles.
- B.
Because these decisions result in increased reimbursement for sponsoring pharma companies.
- C.
Bright line decisions are an agreed upon series of rules that physicians must follow to avoid formulary restrictions
- D.
In order to comply with FDA mandated regulations that are imposed on the interaction between Managed Markets and prescribers.
- 9.What is the definition of the Managed Markets Function?
- A.
A function within a pharma company (or an outside vendor) that is responsible for a specific communications channel.
- B.
A product’s therapeutic classification and its most important competitors.
- C.
The people within a pharma company who are charged with developing a strategy for winning favorable payer coverage of company brands.
- D.
The discrete customer groups that are targeted by pharma companies: trade, federal makerts, MCO’s, Long term care, and Medicaid/medicare.
- 10.What is the definition of the Managed Markets Segment?
- A.
A product’s therapeutic classification and its most important competitors.
- B.
The discrete customer groups that are targeted by pharma companies: trade, federal makerts, MCO’s, Long term care, and Medicaid/medicare
- C.
A function within a pharma company (or an outside vendor) that is responsible for a specific communications channel.
- D.
The people within a pharma company who are charged with developing a strategy for winning favorable payer coverage of company brands.
- 11.What problem(s), if any, does a high co-payment have for patient prescription adherence?
- A.
The higher the co-payment tends to reduce the likelihood that a patient will fill the prescription
- B.
The higher co-payment tends to result in a favorable position on the drug formulary, resulting in higher costs for the patient.
- C.
A and B
- D.
A high co-payment presents no problems for patient compliance.
- 12.Which statement about Medicare Part D is false?
- A.
Medicare part D is the first robust outpatient pharmaceutical benefit from Medicare.
- B.
It’s managed by public entities, which offer drug benefits consistent with the coverage
- C.
It’s the first major outpatient benefit added since the Medicare program began in 1965
- D.
Medicare Part D is an outpatient drug benefit provided by the federal government to people 65+ and the disabled.
- 13.True or False: The Medicare Modernization Act was not a big enough change to the existing Medicare plan to force a change in operations for pharma companies.
- A.
True
- B.
False
- 14.How do managed markets use the entry of new products of similar efficacy as existing blockbusters into the market place to their advantage?
- A.
New products will always be less expensive than existing products to compete with the existing ones.
- B.
Managed markets can use new products to drive the price of existing products down by lowering the formulary status of the existing products
- C.
Managed markets can play new and existing product manufacturers off each other to receive more favorable pricing.
- D.
All of the above
- E.
B and C
- 15.How can the introduction of a generic affect the formulary status of an existing drug, for example, Lipitor?
- A.
Due to the bioequivalence, the generic drug is put on the same level as the existing drug.
- B.
The existing formulary status will always remain the same.
- C.
The formulary status of the existing product might be lowered.
- D.
The formulary status of the existing product might be increased, if possible.
- 16.What is the role of the internal managed markets team?
- A.
To launch the most effective campaign to market a specific product to patients
- B.
To conduct the financial analysis and product valuation required to market a product at the best price
- C.
To make sure the company gets the reimbursement and access status required to maximize performance across the life cycle
- D.
A and B
- E.
All of the above
- 17.What is the marketing effort called when a product is at a disadvantage as compared to its competitors resulting in a difficult task for the sales force?
- A.
A pull through
- B.
A push through
- C.
A bright line idea
- D.
A plan of action
- E.
FUBAR
- 18.Why are managed markets critical to helping a drug reach its full potential?
- A.
Because Managed Markets is the division that creates the promotional platform on which to market a drug.
- B.
Managed Markets is a major component of eliminating sales barriers that keep a drug from reaching its full potential.
- C.
Because Managed Markets hold the relationships with outside sales channels and are the primary influence on prescribers.
- D.
The Managed Markets segment is the primary channel through which sales teams must go, as outlined by their product specific plan of action.
- 19.Match each product with its position on a typical managed care formulary structure: Non preferred brands Disfavored products Preferred Brands Biologics and specialty products Generics
- A.
Highest on formulary Lowest Higher Still higher Full cost often borne by patient
- B.
Still higher Highest on formulary Higher Lowest Full cost often borne by patient
- C.
Still higher Full cost often borne by patient Higher Highest on formulary Lowest
- D.
Still higher Higher Lowest Full cost often borne by patient Highest on formulary
- 20.Which is not a factor that managed markets marketing must take into account when defining an appropriate strategy for securing desired formulary access at target accounts?
- A.
The appropriate access goal
- B.
The strength of the competition
- C.
The key channels and key accounts
- D.
The products value proposition
- E.
The appropriate pricing and contracting strategies
- 21.Why is Tier 2 status not always essential for achieving product success?
- A.
If the expected revenues after contracting aren’t attractive enough to warrant such aggressive discounting/rebates.
- B.
If the required contracting forces the company to jump through too many hurdles.
- C.
If the product is such an improvement over the current treatment, the product will sell itself and will not require a favorable position.
- D.
If the company has a good enough relationship with prescribers to get them to prescribe despite its disfavored formulary position.
- 22.How does managed markets determine on which channels to focus their efforts, i.e. how do they define the key channels?
- A.
Key channels are determined by the patient demographics associated with the product.
- B.
Key channels are determined by with the site of product use/site of care.
- C.
Key channels are determined by level and location of existing competition.
- D.
A and B
- E.
All of the above
- 23.Today, relationships with the Managed Markets channels are a ___________ of corporate and product strategy.
- A.
Derivative
- B.
Customer
- C.
Business unit
- D.
Centerpiece
- E.
Responsibility
- 24.What are the two variables that are used to assess account importance?
- A.
Gross revenue and Size
- B.
Size and level of control in driving utilization of a product
- C.
Level of control in driving utilization of a product and gross revenue
- D.
Type of existing treatment and gross revenue
- 25.Why is price not used as the only consideration when defining the value proposition of a product?
- A.
Managed care plans will take into account the impact of the new product on existing treatments.
- B.
If the benefits of the product far outweigh the benefits of the current treatment, managed care plans may allow an increase in price that is offset by the benefits received.
- C.
If the company can show how their product represents a radical shift in treatment to better the quality of life of the patient, managed care plans may allow an increase in price.
- D.
A and B
- E.
All of the above