Unlike other countries, there is very little government-sponsored healthcare in the US, instead many people have private insurance and healthcare is administered via Health Management Organizations (HMO's).
Conducting cost-effectiveness studies and making submissions for reimbursement from HMO's in the US, which in contrast to Federal agencies are now beginning to request formulary submissions according to the AMCP guidelines, requires a detailed understanding and appreciation for these differences. IMS offers detailed expertise in the US health system and IMS-HEOR staff have assisted in negations with major HMOs in the USA.