Are Workforce Productivity Measures Useful for Formulary Management Decision-Making?
Author(s)
David Tabano, MA, PhD1, Ruchik S. Patel, MBA, RPh, PharmD2, Susan Hogue, MPH, RPh, PharmD2, Stacey Kowal, BS, MSc3, Kate Rosettie, MPH3, Sissi V Pham, PharmD2, Bruce W. Sherman, MD4;
1Genentech, Principal Health Economist, Denver, CO, USA, 2Aesara, Chapel Hill, NC, USA, 3Genentech, South San Francisco, CA, USA, 4Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
1Genentech, Principal Health Economist, Denver, CO, USA, 2Aesara, Chapel Hill, NC, USA, 3Genentech, South San Francisco, CA, USA, 4Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
Presentation Documents
OBJECTIVES: To investigate how US commercial payors and employers incorporate workforce productivity into healthcare coverage decisions, identify opportunities for evidence generation and communicate productivity value messaging to formulary managers.
METHODS: A targeted and gray literature review on intrinsic workforce productivity measures (e.g. well-being, healthy days) and business performance measures (e.g. short- or long-term disability, absenteeism, presenteeism, etc.) for formulary management was conducted, followed by double-blinded interviews with 8 C-suite representatives from US commercial payors and employers in the AESARA payor Center of Excellence. A comprehensive discussion guide was utilized for the interviews.
RESULTS: 8/216 titles met eligibility criteria. While several tools exist for assessing productivity, no peer-reviewed frameworks were identified for comprehensively incorporating productivity measures into payor formulary management decisions. Despite significant economic impact of productivity losses of ~$575 billion in 2019, critical gaps remain in systematic integration of productivity measures into formulary management decisions.
Interviewees recognized productivity as potentially useful, but barriers for broad adoption were emphasized, including the need for standardized definitions and validated measures. Productivity definitions varied based on business sectors and employee demographics. Productivity was an ancillary factor in formulary management decisions, with varying utility across use-cases. Asked to rate the usefulness of productivity for price negotiations and reimbursement on a scale of 0-10 (0= not useful at all; 10= extremely useful), payors rated 2.6, while employers rated 4.6. Interviewees emphasized that productivity measurement must be fit-for-purpose for specific conditions. Employers speculated that demand for productivity measurement would grow due to increasing focus on value in healthcare decision-making. Employers recommended convening cross-functional stakeholders to develop consistent productivity measurement definitions, and a workforce productivity and health value assessment framework.
CONCLUSIONS: Findings highlight discordance in productivity measure utility between payors and employers, and the need for refined, context-specific approaches for defining, capturing and utilizing workforce productivity to support formulary management decisions.
METHODS: A targeted and gray literature review on intrinsic workforce productivity measures (e.g. well-being, healthy days) and business performance measures (e.g. short- or long-term disability, absenteeism, presenteeism, etc.) for formulary management was conducted, followed by double-blinded interviews with 8 C-suite representatives from US commercial payors and employers in the AESARA payor Center of Excellence. A comprehensive discussion guide was utilized for the interviews.
RESULTS: 8/216 titles met eligibility criteria. While several tools exist for assessing productivity, no peer-reviewed frameworks were identified for comprehensively incorporating productivity measures into payor formulary management decisions. Despite significant economic impact of productivity losses of ~$575 billion in 2019, critical gaps remain in systematic integration of productivity measures into formulary management decisions.
Interviewees recognized productivity as potentially useful, but barriers for broad adoption were emphasized, including the need for standardized definitions and validated measures. Productivity definitions varied based on business sectors and employee demographics. Productivity was an ancillary factor in formulary management decisions, with varying utility across use-cases. Asked to rate the usefulness of productivity for price negotiations and reimbursement on a scale of 0-10 (0= not useful at all; 10= extremely useful), payors rated 2.6, while employers rated 4.6. Interviewees emphasized that productivity measurement must be fit-for-purpose for specific conditions. Employers speculated that demand for productivity measurement would grow due to increasing focus on value in healthcare decision-making. Employers recommended convening cross-functional stakeholders to develop consistent productivity measurement definitions, and a workforce productivity and health value assessment framework.
CONCLUSIONS: Findings highlight discordance in productivity measure utility between payors and employers, and the need for refined, context-specific approaches for defining, capturing and utilizing workforce productivity to support formulary management decisions.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE129
Topic
Economic Evaluation
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
No Additional Disease & Conditions/Specialized Treatment Areas