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WellPoint's Contribution To Drug Formulary Evaluation Standards Highlighted in ISPOR Publication
Date:7/2/2009

WellPoint is one of few in the industry providing public access to formulary evaluation standards

INDIANAPOLIS, July 2 /PRNewswire-FirstCall/ -- WellPoint Inc.'s (NYSE: WLP) contribution to creating evidence-based formulary evaluation standards is discussed in the June edition of Value in Health, the journal of the International Society for Pharmacoeconomics and Outcomes Research.

WellPoint is one of few health care management companies that publicly shares its standards on how it establishes its formulary, according to the article, entitled, "Health Technology Assessment in Health-Care Decisions in the United States." The standards are accessible by going to https://www.wellpointnextrx.com/wps/portal/wpo/consultant/druglist/consultantpharmacytherapeutics.

The article was authored by the University of Washington's Sean Sullivan and Scott Ramsey, Premera Blue Cross' John Watkins and WellPoint Chief Clinical Pharmacy Officer Brian Sweet. The publication was funded by a small honorarium from the International Society for Pharmacoeconomics and Outcomes Research.

The authors predict that these evidence-based standards--known as health technology assessment guidelines--will be pushed into a new realm as new evidence is generated from comparative effectiveness research.

"Much of the existing research we have on products is based on how the product performs against a placebo," said Sweet. "That simply isn't enough to ensure that every person gets the treatment that is best for him or her. To improve the quality of health care and to reduce medical costs, we need to know which approach works best and for whom. Comparative effectiveness research can provide additional evidence to be used in formulary evaluations to ensure we make the best health care decisions for our members."

WellPoint revised its evidence requirements for pharmaceutical technology assessments in October, 2008, and shared information about the type of data the company is using to make healthcare decisions on drug therapy with the pharmaceutical and biotechnology industries.

The WellPoint Outcomes-Based Formulary process includes specific requirements for new products, new indications and new formulations and the re-evaluation of products, indications and formulations. Specifically, it asks pharmaceutical manufacturers to provide the following:

  • Impact on patient-reported outcomes, including patient satisfaction, as well as quality of life
  • Potential for medical cost offsets in direct total costs of care and the impact per member per year costs.
  • Potential productivity impacts of introducing patients to the new product
  • Product performance and cost-effectiveness data for up to three years

"Our purpose in sharing this information is to provide drug companies with a clear sense of what we are looking for and to encourage them to invest in research that will produce more meaningful information, which can be used by WellPoint, physicians and members to work toward better health and lower costs," Sweet said.

About WellPoint, Inc.

WellPoint is committed to improving the lives and health of the people and communities we serve by simplifying the connection between health, care and value. Our goal is to help shape the impact each health care decision has on individuals, the health care system at-large, and our communities. WellPoint's more than 42,000 associates work every day to help create the best health care value for our customers. Through collaborations with providers and with innovative programs, WellPoint's affiliated health plans reward healthy lifestyles and quality, safe and effective care. As the nation's largest health benefits company, with more than 35 million members in its affiliated health plans, WellPoint is at the center of the health care system. This position provides us with the relationships and insights needed to help create affordable and actionable solutions that improve health care.

As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), Wisconsin; and through UniCare. Additional information about WellPoint is available at www.wellpoint.com.


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SOURCE WellPoint, Inc.
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