OBJECTIVES: To understand how comparative effectiveness research (CER) is being used by US managed care plans and pharmaceutical benefit managers (PBMs) to control the growth of healthcare costs and ensure appropriate utilization of products by pharmacy and therapeutics (P&T) committees. METHODS: Managed care (MC) medical and pharmacy directors (MDs+PDs) completed an online interactive survey. Topics included: advisor and plan information and current/future coverage of CER. The use of CER and evidence-based medicine (EBM) was evaulated using a 5-point likert scale (5=completely agreeing;1=completely disagreeing). 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. Public (Medicare and Medicaid) and private (Commercial) plans were represented. When asked to select the area emerging CER is expected to affect: value of care (29.8%), optimization/improvement of clinical guidelines (27.7%), appropriateness of care (14.9%), pharmaceutical research and development (6.4%), medical and pharmacy benefit management (17.0%), and 4.3% uncertain. When asked about their agreement in "progress in obtaining usable information on CER of therapies" the results were slightly negative with 42.5% disagreeing (34%=somewhat,8.5%=completely), 38.3% agreeing (4.3%=completely,34%=somewhat), and 19.1% neutral. When asked if they expect their plan to use CER regularly in formulary decision making by 2015, more than half (53.2%,14.9%=completely,38.3%=somewhat) agreed, 27.7% disagreed (23.4%=somewhat,4.3%=completely), and 19.1% were neutral.  When asked to assess how "MC commonly using EBM today in coverage decision making" the results were more favorable with 79.2% agreeing (27.1%=completely,52.1%=somewhat); 14.6% neutral and 6.3% disagreeing (6.3%=somewhat,0%=completely). The most desired change to their plan’s/PBM’s P&T process was for increased use of CER; and a move toward contractual risk-sharing. CONCLUSIONS: Formulary decision making in P&T committees is making progress in the use of comparative effectiveness research. Results suggest that the acceptance of evidence-based medicine is valuable even if not comparative.