Increasingly complex cost-sharing scenarios are a mainstay of today’s healthcare ecosystem.  This complexity has not been captured within legacy formulary tools, which ignore critical details such as deductibles, out-of-pocket maximums, and variability in benefit design.  These complexities create barriers to adoption for innovative life-saving treatments. While insurer claims databases can provide some useful answers, the clarity of insights necessary to guide patient support program development, contracting strategies, critical decisions of brand teams, and field managed markets reimbursement support is often lacking.

Offers the same data as legacy formulary tools plus complex benefit design details across all plans:

• Formulary tier
• Preferred/Non-Preferred status
• PA requirements
• Step edit details
• Medical and pharmacy deductibles
• Out-of-pocket maximums
• Cost sharing (specific to therapeutic type and administration)
• Copays and coinsurance