OBJECTIVES: Understand how medical and pharmacy directors (MDs+PDs) and pharmacy and therapeutics (P&T) committees from public and private health plans, insurers, and PBMs administer formularies, make formulary decisions today, and expected changes for the future. METHODS: Online interactive survey of US MDs+PDs. RESULTS: Fifty-four percent of respondents were MDs, the remainder mostly pharmacists. Most worked for a health plan (83.6%) and 39.6% of the plans were local; 35.4% national; and 25.0% regional and 86% were involved in formulary decisions. AMCP-dossiers are: not-required (52.2%), used for back-ups (39.1%) and used as a basis for reviews (8.9%). Clinician-administered products (ex. office administered injections) are always under the medical-benefit (67.3%), no plans exclusively under the pharmacy-benefit, the remaining 32.7% determine the benefit using cost-thresholds; most plans (72.9%) do not anticipate a change, 18.8% expect a change before 12-2016, 2.1% before 12-2018. Mental health (MH) products were carved-out in 1/3 of plans, conditions with multiple MH therapies required generics first (45%), mandatory step-therapy (37.5%) and require care by a psychiatrist (17.5%). Most were happy with their pharmacy-benefit design, the most requested changes were more restrictive management programs; followed by changes in tiers/co-pays. Most respondent didn’t desire a change to their P&T process; desired changes included more frequent meetings/time; and the use of Comparative Effectiveness Research. Most advisors happy with their plan’s medical-benefit management, the most desired changes included integration of benefits/departments and more restrictive networks. Top current medical concerns: Cancer/oncology, Diabetes and Hepatitis-C. Top current budget concerns Hepatitis-C, Cancer/oncology, and Diabetes. Future areas of concern include biosimilars, immunomodulators, cardiovascular/heart disease; multiple sclerosis; biologics; orphan/rare diseases. CONCLUSIONS:  Managed care uses a variety to tools for formulary managment, including benefit type, mandatory generics and step-therapy. Understanding how decisions are made today and concerns for today and in the future can help guide product development.