Chapter 10 - Managed Markets
-
What role does Managed Markets play internally in a biotech/pharma company?
-
Financial analysis and valuation
-
Promotion and message platform as it relates to newly launched and approved drugs
-
Developing corporate strategies to lead the discovery team
-
Develop and execute strategies to secure access/reimbursement for company products
-
Managed markets, he's our man, if he can't do it, no one can!
Quiz Preview
- 2.
What are the two categories of managed markets?
-
Public and Government
-
Government and Commercial
-
Commercial and Private
-
None of the above
Correct Answer
A. Government and CommercialExplanation
The two categories of managed markets are government and commercial. Government-managed markets are those where the government plays a significant role in regulating and overseeing the market, such as healthcare systems in many countries. Commercial-managed markets, on the other hand, are driven by private companies and organizations that operate within a competitive market environment. These categories represent different approaches to market management and have distinct characteristics and dynamics.Rate this question:
-
- 3.
Select the best example of how managed markets wield their power indirectly:
-
They purchase drugs
-
They assign higher co-payments to disfavored products
-
They utilize restrictions that make it difficult to purchase certain drugs
-
A and C
-
B and C
Correct Answer
A. B and CExplanation
Managed markets wield their power indirectly by assigning higher co-payments to disfavored products and utilizing restrictions that make it difficult to purchase certain drugs. This means that they are indirectly influencing the availability and affordability of certain drugs by making them more expensive or harder to access, thereby exerting their power over the market.Rate this question:
-
- 4.
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.
-
True
-
False
Correct Answer
A. FalseExplanation
The Medicare Modernization Act was a significant change to the existing Medicare plan, which did force a change in operations for pharmaceutical companies. This act introduced the prescription drug benefit (Part D) to Medicare, which required pharmaceutical companies to negotiate prices with the government and offer discounted medications to Medicare beneficiaries. This change had a substantial impact on the operations and pricing strategies of pharmaceutical companies, making the statement false.Rate this question:
-
- 5.
What problem(s), if any, does a high co-payment have for patient prescription adherence?
-
The higher the co-payment tends to reduce the likelihood that a patient will fill the prescription
-
The higher co-payment tends to result in a favorable position on the drug formulary, resulting in higher costs for the patient.
-
A and B
-
A high co-payment presents no problems for patient compliance.
Correct Answer
A. The higher the co-payment tends to reduce the likelihood that a patient will fill the prescriptionExplanation
A high co-payment creates a financial barrier for patients, making it more difficult for them to afford their prescribed medications. This can lead to a decrease in patient adherence, as they may choose not to fill their prescription due to the higher cost. Therefore, the statement "The higher the co-payment tends to reduce the likelihood that a patient will fill the prescription" explains the problem of low prescription adherence caused by high co-payments.Rate this question:
-
- 6.
What is the dominant US managed market segment?
-
Commercial managed care
-
Medicaid
-
Medicare
-
Dept of Veterans Affairs
-
None of the above
Correct Answer
A. Commercial managed careExplanation
The dominant US managed market segment is commercial managed care. This refers to health insurance plans that are provided by private companies and are typically offered to individuals and employees through their employers. Commercial managed care plans often involve a network of healthcare providers and require members to seek care within that network in order to receive the full benefits of their insurance coverage. This segment is dominant because it encompasses a large portion of the population who receive their healthcare coverage through private insurance providers.Rate this question:
-
- 7.
What is the definition of the Managed Markets Segment?
-
A product’s therapeutic classification and its most important competitors.
-
The discrete customer groups that are targeted by pharma companies: trade, federal makerts, MCO’s, Long term care, and Medicaid/medicare
-
A function within a pharma company (or an outside vendor) that is responsible for a specific communications channel.
-
The people within a pharma company who are charged with developing a strategy for winning favorable payer coverage of company brands.
Correct Answer
A. The discrete customer groups that are targeted by pharma companies: trade, federal makerts, MCO’s, Long term care, and Medicaid/medicareExplanation
The Managed Markets Segment refers to the discrete customer groups that are targeted by pharmaceutical companies, including trade, federal markets, MCO's (Managed Care Organizations), long term care, and Medicaid/Medicare. This segment focuses on understanding and meeting the needs of these specific customer groups in order to effectively market and sell pharmaceutical products.Rate this question:
-
- 8.
What two factors are taken into account for the trade-off assessment to determine th effectiveness of contracting?
-
Cost of contracting and cost without contracting
-
Benefits of contracting and cost of contracting
-
Contracting levels of top two competitors
-
Company history and competitor history of contracting for similar products
Correct Answer
A. Benefits of contracting and cost of contractingExplanation
The trade-off assessment for determining the effectiveness of contracting takes into account the benefits of contracting and the cost of contracting. This means that the potential advantages and disadvantages of entering into a contract are considered, as well as the financial implications of the contract itself. By evaluating both the benefits and costs, a company can make an informed decision about whether contracting is a viable option and if it will ultimately be beneficial in terms of value and profitability.Rate this question:
-
- 9.
What is the definition of the Managed Markets Function?
-
A function within a pharma company (or an outside vendor) that is responsible for a specific communications channel.
-
A product’s therapeutic classification and its most important competitors.
-
The people within a pharma company who are charged with developing a strategy for winning favorable payer coverage of company brands.
-
The discrete customer groups that are targeted by pharma companies: trade, federal makerts, MCO’s, Long term care, and Medicaid/medicare.
Correct Answer
A. The people within a pharma company who are charged with developing a strategy for winning favorable payer coverage of company brands.Explanation
The Managed Markets Function refers to the people within a pharmaceutical company who are responsible for developing a strategy to obtain favorable payer coverage for the company's brands. This involves working with payers such as insurance companies and government programs to ensure that the company's products are covered and accessible to patients. The goal of the Managed Markets Function is to maximize the reimbursement and market access for the company's brands.Rate this question:
-
- 10.
How can the introduction of a generic affect the formulary status of an existing drug, for example, Lipitor?
-
Due to the bioequivalence, the generic drug is put on the same level as the existing drug.
-
The existing formulary status will always remain the same.
-
The formulary status of the existing product might be lowered.
-
The formulary status of the existing product might be increased, if possible.
Correct Answer
A. The formulary status of the existing product might be lowered.Explanation
The introduction of a generic drug can potentially lower the formulary status of an existing drug like Lipitor. This is because the generic drug is considered bioequivalent to the existing drug, meaning it has the same active ingredients and produces the same effects in the body. As a result, insurers and healthcare providers may prefer to cover the more cost-effective generic option over the brand-name drug, leading to a potential decrease in the formulary status of the existing drug.Rate this question:
-
- 11.
What are managed market customers?
-
Entities that play a large role in drug reimbursement
-
Large entities that have the power to affect utilization of drugs
-
Entities that determine drug reimbursement procedures
-
A and B
-
B and C
Correct Answer
A. A and BExplanation
Managed market customers are entities that play a large role in drug reimbursement and have the power to affect the utilization of drugs. These customers have the authority to determine drug reimbursement procedures and can significantly impact the market for pharmaceutical products. Therefore, options A and B accurately describe managed market customers.Rate this question:
-
- 12.
How does a major managed care plan steer prescribers away from disfavored drugs?
-
Higher co-pays
-
Require pre-authorization
-
Assign it to tier 1 on a formulary
-
A and B
-
All of the above
Correct Answer
A. A and BExplanation
A major managed care plan steers prescribers away from disfavored drugs by implementing higher co-pays and requiring pre-authorization. Higher co-pays make the disfavored drugs more expensive for patients, discouraging their use. Requiring pre-authorization means that prescribers must seek approval from the managed care plan before prescribing the disfavored drugs, adding an extra step and potential barrier. By combining these two strategies, the managed care plan can effectively influence prescriber behavior and steer them towards using favored drugs instead.Rate this question:
-
- 13.
Why is price not used as the only consideration when defining the value proposition of a product?
-
Managed care plans will take into account the impact of the new product on existing treatments.
-
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.
-
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.
-
A and B
-
All of the above
Correct Answer
A. All of the aboveExplanation
The correct answer is "All of the above." Price is not used as the only consideration when defining the value proposition of a product because managed care plans also take into account the impact of the new product on existing treatments. If the benefits of the product outweigh the benefits of the current treatment, managed care plans may allow an increase in price that is offset by the benefits received. Additionally, if the company can demonstrate that their product represents a radical shift in treatment to improve the quality of life of the patient, managed care plans may also allow an increase in price. Therefore, price alone is not the sole determinant of the value proposition.Rate this question:
-
- 14.
Who is not charged with supporting managed market sales in carrying out the responsibility of contract negotiation?
-
Legal
-
Finance
-
Contracting
-
Marketing
Correct Answer
A. MarketingExplanation
Marketing is not charged with supporting managed market sales in carrying out the responsibility of contract negotiation. While legal, finance, and contracting are all involved in the negotiation process, marketing typically focuses on promoting and advertising products or services, rather than negotiating contracts.Rate this question:
-
- 15.
Which managed market channels are responsible for the vast majority of drug expenditures in the US?
-
Department of Veterans Affairs
-
Department of Defense
-
Medicare
-
Medicaid
-
All of the above
Correct Answer
A. All of the aboveExplanation
The correct answer is "All of the above." The question asks which managed market channels are responsible for the majority of drug expenditures in the US. The Department of Veterans Affairs, Department of Defense, Medicare, and Medicaid are all government programs that provide healthcare coverage and prescription drug benefits. These programs serve a large population and have significant purchasing power, which contributes to their role in driving drug expenditures in the US. Therefore, all of these channels play a part in the majority of drug expenditures in the country.Rate this question:
-
- 16.
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 pull through
-
A push through
-
A bright line idea
-
A plan of action
-
FUBAR
Correct Answer
A. A push throughExplanation
When a product is at a disadvantage compared to its competitors, it becomes difficult for the sales force to promote and sell it. This marketing effort is called a push through. It involves pushing the product aggressively in the market through various promotional activities, discounts, incentives, and persuasive tactics to overcome the disadvantages and increase sales. The aim is to create awareness, generate interest, and convince potential customers to choose the product despite its disadvantages.Rate this question:
-
- 17.
Today, relationships with the Managed Markets channels are a ___________ of corporate and product strategy.
-
Derivative
-
Customer
-
Business unit
-
Centerpiece
-
Responsibility
Correct Answer
A. CenterpieceExplanation
The term "centerpiece" suggests that relationships with the Managed Markets channels are a central and essential component of both corporate and product strategy. This implies that these relationships play a crucial role in driving the success and overall direction of the company and its products.Rate this question:
-
- 18.
Why are managed markets critical to helping a drug reach its full potential?
-
Because Managed Markets is the division that creates the promotional platform on which to market a drug.
-
Managed Markets is a major component of eliminating sales barriers that keep a drug from reaching its full potential.
-
Because Managed Markets hold the relationships with outside sales channels and are the primary influence on prescribers.
-
The Managed Markets segment is the primary channel through which sales teams must go, as outlined by their product specific plan of action.
Correct Answer
A. Managed Markets is a major component of eliminating sales barriers that keep a drug from reaching its full potential.Explanation
Managed Markets is critical to helping a drug reach its full potential because it plays a major role in eliminating sales barriers. This division is responsible for creating the promotional platform to market the drug and holds relationships with outside sales channels. They are also the primary influence on prescribers. Additionally, the Managed Markets segment is the primary channel through which sales teams must go, as outlined by their product specific plan of action. By effectively managing these markets, the division can address and overcome any obstacles that may prevent the drug from reaching its full potential.Rate this question:
-
- 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
-
Highest on formulary Lowest Higher Still higher Full cost often borne by patient
-
Still higher Highest on formulary Higher Lowest Full cost often borne by patient
-
Still higher Full cost often borne by patient Higher Highest on formulary Lowest
-
Still higher Higher Lowest Full cost often borne by patient Highest on formulary
Correct Answer
A. Still higher Full cost often borne by patient Higher Highest on formulary LowestExplanation
The correct answer matches the products with their positions on a typical managed care formulary structure. "Still higher" refers to Non preferred brands or Disfavored products, which are higher on the formulary than other products. "Full cost often borne by patient" refers to Generics, which are typically the lowest on the formulary and have the lowest cost for the patient. "Higher" refers to Preferred Brands, which are higher on the formulary than Generics but lower than Non preferred brands. "Highest on formulary" refers to Biologics and specialty products, which are the highest on the formulary and often have the highest cost for the patient. "Lowest" refers to Non preferred brands or Disfavored products, which are the lowest on the formulary.Rate this question:
-
- 20.
In what way to managed market sales typically interact with field sales?
-
They are teamed up together
-
They have no interaction because their goals and responsibilities are different
-
They are both involved with the development of the plan of action, or pull through plan.
-
Managed market sales defines the plan of action and gives it to the field sales reps to carry out.
Correct Answer
A. They are both involved with the development of the plan of action, or pull through plan.Explanation
Managed market sales and field sales typically interact by being both involved in the development of the plan of action or pull through plan. This suggests that both teams collaborate and contribute to the strategic planning process, working together to create a comprehensive and effective sales strategy. This level of interaction indicates that there is coordination and alignment between managed market sales and field sales, ensuring that they are working towards a common goal.Rate this question:
-
- 21.
How do managed markets use the entry of new products of similar efficacy as existing blockbusters into the market place to their advantage?
-
New products will always be less expensive than existing products to compete with the existing ones.
-
Managed markets can use new products to drive the price of existing products down by lowering the formulary status of the existing products
-
Managed markets can play new and existing product manufacturers off each other to receive more favorable pricing.
-
All of the above
-
B and C
Correct Answer
A. B and CExplanation
Managed markets can use the entry of new products of similar efficacy as existing blockbusters to their advantage by lowering the formulary status of the existing products, which drives their price down. Additionally, they can play new and existing product manufacturers off each other to negotiate more favorable pricing. Both options B and C explain how managed markets can use the entry of new products to their advantage.Rate this question:
-
- 22.
What functions do Account Managers typically NOT focus their efforts to influence?
-
Pharmacy
-
Medical
-
Contracting
-
Quality
-
Regulatory
Correct Answer
A. RegulatoryExplanation
Account Managers typically focus their efforts on areas such as pharmacy, medical, contracting, and quality. However, they do not typically focus their efforts on regulatory matters. Regulatory issues are usually handled by regulatory specialists or compliance teams within an organization. Account Managers may provide support or gather information related to regulatory matters, but their primary focus is usually on other aspects of the business such as sales, customer relationships, and account management.Rate this question:
-
- 23.
How does managed markets determine on which channels to focus their efforts, i.e. how do they define the key channels?
-
Key channels are determined by the patient demographics associated with the product.
-
Key channels are determined by with the site of product use/site of care.
-
Key channels are determined by level and location of existing competition.
-
A and B
-
All of the above
Correct Answer
A. A and BExplanation
The correct answer is A and B. Managed markets determine key channels by considering both the patient demographics associated with the product and the site of product use/site of care. This means that they take into account the characteristics of the target patient population as well as the specific locations or settings where the product will be used or administered. By considering these factors, managed markets can identify the channels that are most relevant and effective for reaching their target audience and delivering the product to the appropriate sites of care.Rate this question:
-
- 24.
When does the managed markets team begin to collaborate with Drug Development and Health Economics and Outcomes Research to define clinical endpoints that substantiates the products value proposition?
-
Phase 1 and 2
-
Phase 2 and 3
-
Phase 3 and 4
-
During Preclinical testing
Correct Answer
A. Phase 2 and 3Explanation
The managed markets team begins to collaborate with Drug Development and Health Economics and Outcomes Research to define clinical endpoints that substantiate the product's value proposition during Phase 2 and 3. This is because Phase 2 involves testing the drug's effectiveness and safety in a larger group of patients, while Phase 3 involves testing the drug in an even larger group of patients to confirm its effectiveness, monitor side effects, and compare it to commonly used treatments. Collaborating during these phases allows the team to gather the necessary data and evidence to support the product's value proposition.Rate this question:
-
- 25.
What are the two variables that are used to assess account importance?
-
Gross revenue and Size
-
Size and level of control in driving utilization of a product
-
Level of control in driving utilization of a product and gross revenue
-
Type of existing treatment and gross revenue
Correct Answer
A. Size and level of control in driving utilization of a productExplanation
Size and level of control in driving utilization of a product are the two variables used to assess account importance. Size refers to the magnitude or scale of the account, such as the number of customers, market share, or revenue generated. Level of control in driving utilization of a product refers to the ability of the account to influence the usage or adoption of a particular product or service. These two variables help determine the significance and impact of an account on overall business performance.Rate this question:
-
- 26.
Why are physicians likely to make bright line decisions?
-
To get into a routine in order to avoid potential prescription hassles.
-
Because these decisions result in increased reimbursement for sponsoring pharma companies.
-
Bright line decisions are an agreed upon series of rules that physicians must follow to avoid formulary restrictions
-
In order to comply with FDA mandated regulations that are imposed on the interaction between Managed Markets and prescribers.
Correct Answer
A. To get into a routine in order to avoid potential prescription hassles.Explanation
Physicians are likely to make bright line decisions in order to get into a routine and avoid potential prescription hassles. This means that by following a set of agreed-upon rules, they can streamline their decision-making process and minimize any complications or challenges that may arise when prescribing medications. By having a clear and consistent approach, physicians can reduce the likelihood of encountering obstacles or restrictions related to formulary requirements or FDA regulations. This approach also allows them to save time and effort by following a standardized procedure for prescribing medications.Rate this question:
-
- 27.
Which factor do managed market sales NOT use to prioritize accounts when determining which should be given the greatest time and attention?
-
Account importance
-
Relationships with certain accounts
-
The need to change existing access status
-
The perceived feasibility of influencing access decisions at that account
Correct Answer
A. Relationships with certain accountsExplanation
Managed market sales do not use relationships with certain accounts to prioritize accounts when determining which should be given the greatest time and attention. This means that the level of relationship with certain accounts does not play a role in deciding which accounts should be given more priority.Rate this question:
-
- 28.
What are the account managers most striving to influence within their accounts?
-
The status of products within the account’s formulary
-
The price of their product
-
The level of reimbursement their product has
-
The type and level of contracting
Correct Answer
A. The status of products within the account’s formularyExplanation
Account managers are most striving to influence the status of products within the account's formulary. This means they are working to ensure that their products are included and given favorable positioning within the account's list of approved medications. By doing so, they can increase the likelihood of their products being prescribed and used by healthcare providers within the account, leading to increased sales and market share.Rate this question:
-
- 29.
What is the role of the internal managed markets team?
-
To launch the most effective campaign to market a specific product to patients
-
To conduct the financial analysis and product valuation required to market a product at the best price
-
To make sure the company gets the reimbursement and access status required to maximize performance across the life cycle
-
A and B
-
All of the above
Correct Answer
A. To make sure the company gets the reimbursement and access status required to maximize performance across the life cycleExplanation
The role of the internal managed markets team is to ensure that the company receives the necessary reimbursement and access status for a product in order to maximize its performance throughout its life cycle. This involves conducting financial analysis and product valuation to determine the best pricing strategy and also launching effective marketing campaigns targeted towards patients. Therefore, the correct answer is "To make sure the company gets the reimbursement and access status required to maximize performance across the life cycle."Rate this question:
-
- 30.
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?
-
The appropriate access goal
-
The strength of the competition
-
The key channels and key accounts
-
The products value proposition
-
The appropriate pricing and contracting strategies
Correct Answer
A. The strength of the competitionExplanation
When defining an appropriate strategy for securing desired formulary access at target accounts, managed markets marketing must take into account various factors. These factors include the appropriate access goal, the key channels and key accounts, the product's value proposition, and the appropriate pricing and contracting strategies. However, the strength of the competition is not a factor that managed markets marketing needs to consider when defining their strategy.Rate this question:
-
- 31.
Which statement about Medicare Part D is false?
-
Medicare part D is the first robust outpatient pharmaceutical benefit from Medicare.
-
It’s managed by public entities, which offer drug benefits consistent with the coverage
-
It’s the first major outpatient benefit added since the Medicare program began in 1965
-
Medicare Part D is an outpatient drug benefit provided by the federal government to people 65+ and the disabled.
Correct Answer
A. It’s managed by public entities, which offer drug benefits consistent with the coverageExplanation
The statement that is false is "It’s managed by public entities, which offer drug benefits consistent with the coverage." Medicare Part D is actually managed by private insurance companies that are approved by Medicare. These private insurance companies offer drug benefits that are consistent with the coverage guidelines set by Medicare.Rate this question:
-
- 32.
Why is Tier 2 status not always essential for achieving product success?
-
If the expected revenues after contracting aren’t attractive enough to warrant such aggressive discounting/rebates.
-
If the required contracting forces the company to jump through too many hurdles.
-
If the product is such an improvement over the current treatment, the product will sell itself and will not require a favorable position.
-
If the company has a good enough relationship with prescribers to get them to prescribe despite its disfavored formulary position.
Correct Answer
A. If the expected revenues after contracting aren’t attractive enough to warrant such aggressive discounting/rebates.Explanation
Tier 2 status is not always essential for achieving product success because if the expected revenues after contracting are not attractive enough to justify aggressive discounting or rebates, it may not be worth pursuing. In other words, if the potential financial gains from securing Tier 2 status do not outweigh the costs and efforts required, it may be more beneficial for the company to focus on other strategies to promote and sell the product.Rate this question:
-
Quiz Review Timeline (Updated): Mar 21, 2023 +
Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
-
Current Version
-
Mar 21, 2023Quiz Edited by
ProProfs Editorial Team -
Feb 26, 2009Quiz Created by
Msquared
Back to top