**GOLD RIBBON WINNER** This research discussed eight trends on the current and future extent of formulary decision-making and utilization management for specialty products in Commercial and Medicare lives. Developers must be proactive to understand current reauthorization environment for their product’s respective indication and competition.

This research assesses both, status quo of novel payment strategies across Commercial and Medicare lives, and opportunities for future expansion within three years. Despite heightened excitement around innovative financing models, MCOs in the US see limited to no current use, and they have narrow plans of future implementation. But we found that some pockets of the future do exist in the present.