2nd Quarter 2008

The Role of the Academy of Managed Care Pharmacy (AMCP) Format in Managed Care Formulary and Coverage Decisionmaking

By Caroline Schaefer, Cara Santillo, Jason Lerner

Established in 2000, the AMCP Format for Formulary Submissions provides a standard template for manufacturers to present information about new pharmaceuticals to managed-care formulary committees.¹

Covance recently surveyed 22 members of our expert panel of pharmacy and medical directors to learn more about adoption and use of the AMCP format in managed care formulary and coverage decisionmaking.

Below are the highlights of our research:

• For drugs covered under the pharmacy benefit, 82 percent of respondents require, recommend, or use the AMCP format to support formulary or coverage decisions (n = 22). This compares to 68 percent for drugs covered under the medical benefit.

Exhibit 1

Drugs Covered Under the Pharmacy Benefit (n = 22)	Drugs Covered Under the Medical Benefit (n = 22)

• Among plans that require, recommend, or use the AMCP format , the section of the AMCP format that describes supporting clinical and economic information (Section 2.0) is considered most useful; the modeling report (Section 3.0) is least useful.

Exhibit 2

• Half of plans report using the budget-impact model results during their review, and 28 percent report using the cost-effectiveness model results; however, not all AMCP format submissions include complete economic model information, as recommended by the guidelines. Plans report that about 25 percent of AMCP dossiers include a modeling report but no model, and 30 percent are submitted without a model nor a modeling report.
• Over the past 24 months, plans using the AMCP format sought out a specific reprint request for 17 percent (range: 0-80 percent) of submissions, requested an unlocked version of the model that could be used to run internal analyses for 15 percent (range: 0-100 percent) of submissions, modified the provided model with plan-specific parameter estimates for 14 percent (range: 0-36 percent) of submissions, conducted their own internal literature review for 80 percent (range: 0-100 percent) of submissions, and identified key information that was omitted from the AMCP format submission for 15 percent (0-40 percent) of submissions.
• A majority of plans that require, recommend/prefer, or use the AMCP format perceive its availability to expedite (53 percent of plans) and/or increase efficiency of (71 percent) the drug review process.

Exhibit 3

The Value of the AMCP Dossier in the Drug Review Process

Research results were presented at the International Society for Pharmacoeconomics and Outcomes Research conference.² For more information about AMCP dossiers, contact Caroline Schaefer or Jason Lerner.