Expert Guidance and Strategy Development

CREATING OPPORTUNITY IN MEDICAID


MEDICAID IS COMPLEX

Each state has its own systems, policies and procedures for determination of drug coverage on Preferred Drug Lists (PDLs).

Each state also varies in the proportion of its Medicaid population covered under FFS vs. MM plans and approaches for product market access/coverage in FFS and MM plans can vary.

Each state sets its own schedules for product and class reviews and differs in its policies and processes for manufacturer participation.


There are a number of factors to consider when planning a strategy for access in Medicaid:

  • Which states are important targets?
  • Is the state part of a purchasing pool?
  • Do Managed Medicaid plans follow the state preferred drug list (PDL)?
  • Do clinical edit nuances exist for products in this class?
  • What is the current formulary status?
  • Is this a defensive or offensive strategy?
  • What is the utilization? How are restrictions (e.g., PAs) being driven?
  • Does/will the Pharmacy Benefit Administrator (PBA) recommend the product be added to the PDL?

Viking can help you answer these questions – and work with you to develop and execute a successful market access strategy in the Medicaid market.



VIKING’S MEDICAID EXPERTISE

With decades of experience, high credibility and recognition among Medicaid decision-makers across the US, Viking uses its depth of knowledge to navigate the complex and ever-evolving requirements of the government to successfully secure product access in Fee For Service (FFS) and Managed Medicaid (MM) channels.


IT STARTS WITH A CONVERSATION

Viking is a valued resource to both payers and manufacturers.

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