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Payers prefer objective data on mental health medications

April 14, 2017
by Tom Valentino, Senior Editor
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While advocacy groups in mental health push for greater input from patients in clinical trials, private payers are more interested in data that shows whether a drug delivers on its purpose, according to research released this month by inVentiv Health, a professional services organization for the biopharmaceutical industry.

Executives interviewed for the inVentiv whitepaper released this month, who are responsible for reimbursement and formulary decisions about regional and national health plans covering more than 59 million Americans, acknowledge that subjectivity is inevitable when discussing medications designed to treat symptoms of mental illness. Still, 92% of respondents say they do not wish to see wider use of patient-reported outcome measures that track patients’ wishes and experiences in their own voices, unamended by clinicians, when discussing new drugs with manufacturers.

Other findings in the whitepaper:

  • Payers interviewed say mental health is a moderately expensive condition, with costs concentrated in hospitalizations and inpatient care, rather than pharmacy costs, thanks to a wide availability of generic mental health medications. As such, just 23% of payers say they employ “fail first” policies that require patients try generic treatments before switching to their more expensive branded counterparts.
  • Nearly seven in 10 payers (69%) interviewed were similarly skeptical of health economics and outcomes research generated by product marketers without corroboration by an impartial third party. Said one respondent interviewed in the inVentiv whitepaper: “No manufacturer has ever publicized a study that didn’t show their product saving payers stacks of money, but these savings are rarely, if ever, realized within the payer’s own plan.”