A Funny Thing Happened on the Way to a Formulary Decision

October 13, 2016

Article by:

Camm Epstein
Founder
Currant Insights

While P&T committee meetings are typically serious and professional, like all social situations, funny things can happen. Pharmacy and medical directors representing the largest payers have no trouble recounting funny things they have seen during P&T committee meetings.

A different kind of rationing

In one case, erectile dysfunction (the condition itself) was not humorous, but the conversation surrounding monthly quantity limits for ED products was a source of laughter. By the way, the quantity limit was set at four times a month — and for those good at math, that’s an average of once a week.

Too much information

In another case, members of the committee shared their personal experiences with ED products.

Smile, you’re on candid camera

Picture this: One of the payer’s subject matter experts addresses the P&T committee, unaware of the spinach covering her front tooth.

Indecent disclosures

Or this: A primary care provider initially advocated for a new expensive branded product in a crowded and poorly differentiated market. Later, when the drug was going generic, he disclosed that he had been dating the drug rep when the drug was launched.

You can’t make this stuff up

Then there was the committee that attempted to reduce the number of covered, branded SSRIs on formulary from three to two. To help inform the committee’s decision, psychiatrists were brought in to present — only to have a raging argument among themselves about which product was best.

Sure, there are some lessons embedded in these stories, and even some value in simply retelling a story that may elicit some laughs — or, at least, smirks. Of perhaps greater importance is the reminder that P&T committee members can find things funny, and humor is a very common human experience. P&T committee members are human and may perceive P&T committee situations as funny — not to mention sad, frustrating, or rewarding. Marketers and market researchers don’t call on, interview, or survey “payers” — they reach out to people (e.g., clinical pharmacists, pharmacy directors, medical directors) with complex perceptions and behaviors and who are members of groups embedded in large, complex organizations.

Manufacturers should anticipate the potential emotional response of P&T committee members to their products, their pricing and contracting actions, and their communications. Doing so may make their efforts to market to and research payers more effective. Recalling funny things that happened on the way to formulary decisions can be a serious reminder of the needs and wants of this target audience.

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