What a year for uncertainty this has been. We began the year with new policy announcements from the executive branch with seemingly massive implications for manufacturers and payers. As the implementation dates drew closer, however, those policies were turned back. Resources in terms of person-power, time, and money spent on complying with these proposed and rescinded policies were wasted.

From the perspective of a regional health plan, this environmental turmoil often can lead to organizational turmoil. When uncertainty gets turned up to 11, already constrained resources become even more so. As a result, familiar touch points for manufacturers may be fewer or nonresponsive due to a high number of competing priorities, or they may have disappeared altogether. Time allotted for discussing new products or indications may become significantly reduced or establishing relationships with new and less experienced health plan team members may occur.

In this situation, the need for the health plan to see value in these interactions will be critical. Indeed, communication needs to be clear, concise, and meaningful to the recipient. How can this be accomplished and remain compliant with regulation and corporate policy? Here are a few broad tips from a former payer decision maker:

  • Understand the perspective of the (health plan) recipient
    • Time is valuable
      • Agree on the topics up front
      • Check if extra time is available at the beginning of the meeting—nothing is as abrasive to a harried health plan executive than to hear “just one more thing” when your time is up
    • Courtesy opens doors
      • If time is almost up, check to see if/when a follow-up meeting can occur
    • Present clear and concise messages
      • Within the constraints of compliance, review the main topic or purpose of the meeting as quickly as possible
        • A health plan may want to skip the up-front safety information in a product presentation, but remind them of compliance and move as expediently as possible
      • Sometimes we see a squirrel
        • It’s inevitable that a health plan team member will go off topic
          • Determine the conversation and if there’s not a clear linkage, get back on track by redirecting them to the topic of the presentation

While the government was aggressive in its push for multiple policies aimed at drug price transparency, many did not pass—which still affected payers. As payers continue to monitor the legislative landscape and scramble to update systems and operations to comply if policies are implemented, manufacturers need to continue relationships and bring forward concise messages that bring value to payers.