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U.S. Physician Prescribing Behavior Impacted by Health Insurance Exchanges and Accountable Care Organizations
Date:10/24/2013

BURLINGTON, Mass., Oct. 24, 2013 /PRNewswire/ -- Decision Resources Group, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that pharmaceutical companies are facing a paradigm shift in the way their brands gain access to the U.S. market, as Accountable Care Organizations (ACOs) continue to develop across the nation and enrollment on the health insurance exchanges moves forward.

"Through our comprehensive surveys of physicians and MCO executives, we're able to see how the enormous changes in the U.S. healthcare market are affecting pharmaceutical brands.  When we looked at currently available and emerging brands by therapy, it was clear that some will benefit and others will be challenged," said Roy Moore, Senior Director at Decision Resources, a Decision Resources Group company. "For instance, looking at schizophrenia and depression, physician and payer responses suggest constrained use of branded therapies on exchange-based plans because of generic competition—even though they feel Abilify and Cymbalta will remain popular therapies. In light of the new dynamics shaping reimbursement decisions, pharmaceutical brand teams looking forward to 2014 vs. backward to 2013 will be crafting market access strategies that take changes like these into account."

ACOs, of which there are more than 500 across the US, will also impact prescribing behavior and brand uptake across therapies. For example, half of surveyed pulmonologists who participate in an ACO reduced their prescribing of the branded leukotriene inhibitor Singulair—while one-third assigned more of their patients to montelukast, a generic form of the same drug favored by ACO policies such as co-pay reductions. Similarly, 43% report they are less likely to prescribe Dulera because of their participation in an ACO whereas only 13% report increased prescribing of this agent.
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SOURCE Decision Resources Group
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