SPOTLIGHT ON MARKET ACCESS
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2021 Spotlight on Market Access
Medicaid, Medicare Drug Reimbursement Is Facing Significant Changes in Policy
June 7th, 2021
- Uncertainties Swirl Around Management, Pricing of COVID Vaccines Post Pandemic
- Specialty Drug Spending May Be Slowed by Biosimilars
- Chart: Global Oncology Spending and Growth
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2021 Spotlight on Market Access
Research Shows COVID’s Impact on Health Care Has Lessened but Not Disappeared
May 17th, 2021
- Fotivda Approval Provides New Option for Certain People With Renal Cell Carcinoma
- Chart: Anticipated Prescribing Actions for Tivozanib Assuming FDA Approval
- Reality Check: Hereditary Angioedema
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Pharma Is Stepping Up Focus on SDoH, Urging Use of Data-Driven Approach
May 3rd, 2021
- Pharmaceutical Industry Should Undergo Various Steps to Help Rebuild Public Trust
- Infographic: Health Care Spending Bounces Back but Still Falls 1% Year Over Year
- CVS-CTCA Pilot Offers In-Home Infusion of Cancer Therapies
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People on Specialty Drugs May Need to Alter Dosing When Getting COVID Vaccine
April 19th, 2021
- FDA Approves New Long-Acting HIV Regimen That Could Help Adherence
- Infographic: One-Third of U.S. Adults Delayed or Skipped Health Care During Pandemic
- Reality Check: Migraine Prevention
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Pharma Manufacturers Face New Medicaid Landscape as States Carve Out Drug Benefit
March 1st, 2021
- Medicine’s Evolution Has Brought Novel New Products, Opportunities for Pharma
- Orgovyx Offers New Oral Option for Prostate Cancer
- Chart: Oncologists’ Anticipated Prescribing Actions for Relugolix Assuming FDA Approval
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Pharma Innovation Is Poised to Continue Beyond COVID Vaccines, Drugs This Year
January 18th, 2021
- Biosimilars May Be at Risk Depending On Supreme Court’s Affordable Care Act Ruling
- Infographic: Specialty Drug Spending Continues to Rise, Driven by Higher Utilization
- Reality Check: Metastatic Prostate Cancer
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FDA’s Evaluation of Certain Cancer Drugs Illustrates Risk/Reward Balance Needed
April 5th, 2021
- Vaccine Rollout, Ensuing Commercialization Offer Lessons for Pharma, Experts Maintain
- How Will Biden Administration Handle Copay Accumulators?
- Infographic: Copay Accumulator Usage Is on the Rise
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Shields’ Purchase of Excelera Highlights Integrated Specialty Pharmacy industry
February 15th, 2021
- Administration Delays Implementation of Rebate Rule; Congress Is Likely to Repeal It
- Infographic: Hike in Drug List Prices Has Downstream Effect on Patient, Payer Costs
- Reality Check: Epilepsy
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Unsurprisingly, COVID Pandemic and Race For Vaccine Led 2020 Pharma Headlines
January 4th, 2021
- IDNs Are Spearheading Research Projects To Examine Specialty Pharmacy Outcomes
- With Oxlumo FDA OK, Alnylam Unveils Value-Based Program
- Infographic: By the Numbers: The National Health Insurance Market in 2020
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Development of COVID-19 Vaccines, Tests, Therapeutics Could Have Broader Impact
March 15th, 2021
- FDA Approval Makes Breyanzi Third CAR-T Therapy in Non-Hodgkin’s Lymphoma
- Chart: Oncologists’ Anticipated Site of Administration for CAR-T Therapies Assuming Approval of Liso-Cel
- Reality Check: Triple-Negative Breast Cancer
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Value-Based Pricing Interest Stays High, But Headwinds Could Hamper Uptake
February 1st, 2021
- Survey Shows That Copay Accumulators And Maximizers Continue to Be Popular
- Chart: Utilization and Coverage Under Copay Accumulator/ Maximizer Programs
- Centene Boosts Specialty Drug Expertise With Pair of Deals
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2020 Spotlight on Market Access
Administration Issues Drug Pricing Rules That May Have Unintended Outcomes
December 21st, 2020
- Anthem Oncology Pay-for-Performance Program Boosted Evidence-Based Care
- Infographic: COVID-19 Causes Unprecedented Drop in Health Care Spending
- Reality Check: Growth Hormone Deficiency
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2020 Spotlight on Market Access
Oncology Care Faces Major Disruption, Changes in Wake of COVID-19 Pandemic
December 7th, 2020
- Strategies Can Address Challenges With Follow-Up Studies for Cell, Gene Therapies
- ‘Drug Super Spender’ Members Doubled Over Four-Year Span
- Infographic: Part D, Private Plan Spending Rises on Retail Specialty Drugs
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Start Early in Planning Variety of Payer And Provider Commercialization Tactics
November 16th, 2020
- Study Finds Cancer-Related Services Have Dropped, Could Have Long-Lasting Impact
- Infographic: Pharma Industry Spent Big on Lobbying Amid COVID-19, Election
- Reality Check: Anemia — Chronic Kidney Disease
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Pharma Industry’s Focus on High-Cost Drugs May Provoke More Access Barriers
November 2nd, 2020
- Real-World Evidence Has Crucial Role To Play in Race to COVID-19 Approvals
- FDA Approval of Sogroya May Change Prescribing in GH Class
- Chart: Payers’ Anticipated Reaction to the Introduction of Long-Acting GHD Therapies
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As COVID-19 Pandemic Persists, People Need to Access Essential Services Safely
September 21st, 2020
- Anemia Due to Chronic Kidney Disease May See First-in-Class Drug This Year
- Infographic: Health Services Utilization Index
- Reality Check: Non-Small Cell Lung Cancer Systemic Therapy
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COVID Emphasizes Collaborative Approach That’s Needed to Assess Health Care Value
August 3rd, 2020
- COVID-19 Manufacturer Market Access Challenges Include Speed, Scale, Pricing
- Infographic: How Close Are We to a Coronavirus Vaccine?
- DOJ, Pharma Renew Disputes Over Charitable Foundations
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Study: Pandemic May Result in Shift From Part B to Part D for Autoimmune Drugs
June 15th, 2020
- With One Drug Supply Issue In Check, ‘Buy American’ May Prompt Another
- Infographic: CVS Reports Lowest Drug Trend in Years
- Reality Check: Bipolar Disorder
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COVID-19 Pandemic Is Resulting in Array Of Changes That Will Transform Pharma
May 4th, 2020
- Start Launch Planning, Contact Payers Early in Development for Best Results
- Plan Will Cover Whole Genome Sequencing for Ill Children
- Chart: Ranking of Meeting Formats for Remotely Working/Meetings With Pharma MSLs/Account Managers
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Prior Authorization Can Be Challenging For MDs; Pharma Can Help With Process
March 16th, 2020
- Drug Prices, Biosimilars and Gene Therapies Are Among Expected 2020 Industry Trends
- Chart: Health Care Affordability Is Top of Mind for Voters
- Reality Check: Chronic Lymphocytic Leukemia
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New Orphan Drug Playing Field Requires Change in Tactics for Pharma Companies
February 3rd, 2020
- Manufacturers May Employ Variety of Tactics to Ensure Favorable Drug Launch
- Chart: The Preapproval Information Payers Value Most
- HHS Importation Efforts Move Ahead, but Questions Remain
- Chart: Share of Drugs Approved in 1998-2017 by Type
- Chart: Annual Cost of Drugs at Launch: 1998-2017
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Drugmakers Could Gain Market Share by Partnering With Calif. on New Initiative
October 19th, 2020
- Allogeneic Process Might Help Make CAR-T Therapies Less Expensive, Easier to Make
- Chart: Little Is Spent on Treating High-Cost Patients’ Behavioral Health Conditions
- Reality Check: Sickle Cell Disease
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Virtual FDA Meetings in COVID-19 Era Highlight Need for Revised Preparation
September 7th, 2020
- Challenges Exist for Drugmakers in ‘Buy American’ Executive Order Implementation
- Two PARP Inhibitors OK’d for New Prostate Cancer Indication
- Infographic: Effectuated ACA Exchange Enrollment Rises Slightly in Early 2020
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CMS Proposes Changes to Medicaid Best Price to Encourage VBP Arrangements
July 20th, 2020
- CMS Reverses Stance, Will Allow Copay Accumulators for Drugs With No Generics
- Chart: Payers’ Adoption of Copay Accumulator Programs
- Reality Check: Duchenne Muscular Dystrophy
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COVID Is Having Impact on Cancer Care, Will Transform It For Patients, Providers
June 1st, 2020
- IDNs and Employers Are Seeking Savings By Cutting Out Health Insurer ‘Middlemen’
- Report: Oncology Drives Rise in Medical Benefit Drug Spend
- Source: Pandemic Poses ‘Major Disruption’ to My Cancer Care
- Chart: Modeled Impact of Reduced Screening Tests Three Months Ending June 5, 2020
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As COVID-19 Highlights Pharma Innovation, How Might It Impact Opinions of Industry?
April 20th, 2020
- Providers Protest New Tennessee Blues Plan Policy Intended to Save Clients Money
- Experts Vary on Challenges, Benefits of White Bagging
- Infographic: Current/Anticipated Office-Administered Non-Oncology Therapy Per Distribution Channel
- White Bagging Can Pose Array of Logistical, Contractual and Communication Issues
- Reality Check: Type 2 Diabetes (GLP-1 and Combo)
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Manufacturers Have Growing Interest in Getting Real-World Data, Dispelling Issues
March 2nd, 2020
- Drugmakers Change Up Tactics to Leverage MD Relationships to Obtain Payer Coverage
- Multiple Oncology Biosimilars Could Prompt Preferencing
- Chart: Minimum Number of Available Biosimilars Required to Accept Preferred Contracts
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Drug Prices, Health Technology, Novel New Products Will Be in 2020 Pharma Headlines
January 20th, 2020
- Study Examines Adherence Rates, Out-Of-Pocket Costs for Cystic Fibrosis CFTR Drugs
- Chart: What Impact on the Deal-Making Climate Do You Think Each of the Following Disruptors Will Have?
- Reality Check: Migraine
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Administration Continues With Drug Price Efforts, but Questions, Issues Remain
October 5th, 2020
- GPOs Eye Branded, Specialty Products as Insurer-Owned PBMs Launch Competitors
- Recently Approved Evrysdi May Have Big Impact on Class
- Chart: Payers’ Likelihood of Taking Management Steps for Risdiplam for the Treatment of SMA
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Impact, Feasibility, logistics of Executive Orders on Drug Pricing Are Questioned
August 17th, 2020
- Banner Prepares to Launch Generic Novel Fumarate Bafiertam in Multiple Sclerosis
- Infographic: Medicaid Pays Millions in Excess Costs Due to Delayed Generic Drug Entry
- Reality Check: Ankylosing Spondylitis
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Virtual Pharma-Payer Negotiations May Require More Persistence in COVID-19 Era
July 6th, 2020
- As More Clinical Trial Services Shift To Alternate Sites, Changes May Stick
- Study Shows High Adherence in People on CDK 4/6 Inhibitors
- Chart: Prioritization of Making Decisions on Scheduling Meetings With Pharma MSLs/Account Managers
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COVID-19 Is Causing Changes to Models, Entities Throughout Health Care Landscape
May 18th, 2020
- Prime Studies Show High Costs Among Asthma, Hereditary Angioedema Biologics
- Chart: Physician Interactions in Week Ending April 3, 2020
- Reality Check: Multiple Sclerosis
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Pharma Firms Face Numerous COVID-19 Challenges but Still Can Help Other Entities
April 6th, 2020
- Learn How Payers Think, Solve Data Issues To Enact More Complex Value-Based Pacts
- CVS Health Offers Genomic Testing for More Precise Care
- Infographic: Pharma Companies Race to Tackle COVID-19
- Pharma Manufacturers Can Take Multiple Steps to Protect On-Site Employees
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Real-World Data Can Take on Multitude Of Forms and Offers Variety of Benefits
February 17th, 2020
- Louisiana Touts Fast Start for New Five-Year Hepatitis C ‘Netflix’ Model With Asegua
- Chart: People With Hepatitis C Treated in Louisiana Medicaid and State Corrections
- Reality Check: Cystic Fibrosis
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Innovative New Therapies, Uptick in M&A Activity Were Some 2019 Pharma Highlights
January 6th, 2020
- Pharma Manufacturers Could See Better Adherence, Outcomes With Focus on SDOH
- Highmark Unveils Hemophilia Effort Focused on Care, Costs
- Chart: U.S. Spending on Retail Prescription Drugs Grows Moderately in 2018
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2019 Spotlight on Market Access
NDC Mandates May Offer Medical Benefit Spend Clarity, but Payer Challenges Exist
December 16th, 2019
- Alnylam Offers Value-Based Agreements, Prevalence-Based Adjustment for Givlaari
- Chart: Future NDC Data Collection
- Chart: Current NDC Data Collection
- Chart: Payer NDC Data Collection
- Reality Check: Parkinson’s Disease
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2019 Spotlight on Market Access
ICER Will Take Different Approach to Assess Short-Term, High-Impact Products
December 2nd, 2019
- As Health Care Consolidation Accelerates, New Entities Make Decisions on Therapies
- Infographic: Generic Drug Approvals Hit Another Record in Fiscal Year 2019
- Study: NSCLC EGFR-i May Be Fit for Value-Based Contracts
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As Step Therapy Use Increases, Federal and State Bills Are Taking Aim at Payer Strategy
November 18th, 2019
- ICER Releases Report on Drug Price Hikes; Opinions Vary on Its Usefulness, Impact
- Chart: Influence of ICER’s Assessments on Payers’ Decision-Making Is Likely to Increase
- Chart: ICER Reports Have Influenced Payers to Support Risk/Value-Based Contracting
- Reality Check: Narcolepsy
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Precision Medicine Hits N of 1 Milestone but Still Faces Many Cost, Regulatory Obstacles
November 4th, 2019
- Health Systems Can Reap Multiple Benefits By Offering Specialty Pharmacy Capabilities
- Source: Some Misconceptions Exist Around Health System Specialty Pharmacies
- IL-17 Use in Psoriasis Grows as Adherence, Outcomes Rise
- Chart: Personalized Medicines Top 30% of FDA Approvals for Second Year in a Row
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Recent Situations Stress That Data Is More Important Than Ever to FDA, Drug Uptake
September 16th, 2019
- Report Reveals That Almost 100 RM/AT Products Are in Phase III Clinical Trials
- Clinical Trials by Indication: Q2 2019
- Reality Check: PCSK9 Inhibitors
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Drug Pricing Proposals Have Undergone Flurry of Increased Activity Recently
August 5th, 2019
- Stakeholders Want Data on Value of New Oncolytics, Place in Treatment Algorithms
- Will Blockchain Transform Relationships Industrywide?
- AARP Report Shows Prices for Specialty Medications Continue to Increase
- Average Annual Price of Specialty Drugs Almost Tripled Between 2006 and 2017
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How Much Impact Will Interchangeability Guidance Have on Biosimilars’ Uptake?
June 17th, 2019
- Oncology Is Seeing Surge of Innovation, As Well as Double-Digit Spending Growth
- Top 25 Cancers and the Number of Mechanisms Targeting Each, Phase I Through Pre-Registration Within Immuno-Oncology Pipeline
- Reality Check: Multiple Sclerosis
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Stakeholders Skeptical of Major Potential Effect From Amazon’s Health Care Plays
May 6th, 2019
- In Burgeoning Oncology Space, Payers Are Looking to Pharma for Data to Assess Value
- Companies Partner Up to Offer First Digital Oncology Medicine
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As Use of Copay Accumulators Increases, Pharma Tactics Can Help Blunt Their Effects
March 18th, 2019
- ANPRM Reportedly Prompts PhRMA to Mull Limiting Members’ Price Increases
- Charts: Payers’ Current and Anticipated Status of Copay Accumulator Programs
- Reality Check: Growth Hormones
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2018 Trends of Innovative Therapies, Focus On Drug Prices Are Likely to Continue in ’19
February 4th, 2019
- Biomarkers Are Helping Drive Research, Commercialization of New Treatments
- Drug Importation Could Offer Savings for Vermont Payers
- Chart: What to watch in 2019 — biopharma’s most valuable R&D projects
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Manufacturers Must Address Challenges in Paying for, Showing Value of New Therapies
October 21st, 2019
- Louisiana Took Long Path to Modified Subscription Model for Hepatitis C Drugs
- Number of Next-Generation Biotherapeutic Pipeline Products in Late-Stage Pipeline, 2014–2018
- What Are Other Reimbursement Models for Novel New Therapies?
- Reality Check: Acute Myeloid Leukemia
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FDA Guidance Encourages New Focus on Alzheimer’s Biomarkers, Early Detection
September 2nd, 2019
- Conveying Value of Accelerated Approval Drugs May Be Challenge for Pharma Firms
- FDA’s Project Facilitate Aims to Improve Access to Unapproved Therapies
- Large Employers Are Worried About Pipeline of Costly Drugs
- Chart: 102 Drugs to Treat Alzheimer’s Are in Clinical Trials
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IDNs, Pharma Manufacturers Can Both Reap Benefits From Direct Contracting
July 15th, 2019
- Some Practices Now Are Taking Two-Sided Risk in CMS’s Oncology Care Model Pilot
- Study: Expensive Novel Drugs Launched After OCM Baseline Period Are Hamstringing MDs
- Chart: Top 7 Unaided Reasons Why IDNs Want to Direct Contract With Pharma
- Chart: Aided Reasons for IDN Direct Contracting With Pharma
- Chart: IDN Decision Makers Explain Why Manufacturers Should Direct Contract
- Reality Check: Glaucoma
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Final Rule Requiring Drug Prices’ Inclusion In DTC Ads May Have Unplanned Outcomes
June 3rd, 2019
- Pharma Data, Patient Support Are Critical In Engaging MDs and Winning Their Trust
- Prime Analyzed Current, Future Costs for SMA and CF Therapies
- Infographic: Pharmaceutical Industry, PBMs Spend Near Record-Breaking Sum on Lobbying Under Pressure on Drug Prices
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2019 Starts Out Strong in M&A Activity, With Focus on Oncology, Gene Therapies
April 15th, 2019
- Payers Are Specifying Duration of Steps Required for Inflammatory Class Biologics
- Indication-Based Formularies Are Growing in Use for Inflammatory Conditions
- Will Payers Prefer Biologic Anti-Inflammatories Within Certain Mechanisms of Action?
- Gene Therapies, Payer Mix Present Challenges for Pharmaceutical Company Acquirers
- Reality Check: Immune Globulin (PID)
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Pharma and Payers Should Collaborate on Novel Payment Models for Costly Therapies
March 4th, 2019
- PBMs Are Looking to Pharma Industry Data, Analytics to Manage Medical Benefit Drugs
- Drugs With Unsupported Price Increases Are in ICER Crosshairs
- Chart: Invoice Spending on Medications Is Expected to Hit $600 Billion by 2023
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Oncology Drugs, CGRP Agents, Biosimilars Were Among Impactful Approvals in 2018
January 21st, 2019
- GAO Report Maintains FDA Could Improve Orphan Designation Application Reviews
- Chart: Therapeutic Areas of Orphan Drug Marketing Approvals from 2008 to 2017
- Reality Check: Cystic Fibrosis
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Will Various Drug Pricing Efforts Endanger Innovation Within Pharma? Opinions Vary
October 7th, 2019
- Visibility Into Cost, Coverage Information Is Key for Providers, but Progress Is Slow
- Medicare Part D Drug Rebates Reduced Drug Spending, OIG Report Shows
- Payers’ Coverage Factors for Rozlytrek Will Go Beyond Cost
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HHS and FDA Outline Importation Plan, but Savings and Timing of Actions Are Unclear
August 19th, 2019
- Senate Drug Pricing Bill Takes Expansive Approach, Could Provide Huge Savings
- More Than 1M Medicare Part D Enrollees Had High Out-of-Pocket Drug Spending in 2017
- Reality Check: Major Depressive Disorder
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Natural Language Processing Has Promise In Drug Discovery, Patient Identification
July 1st, 2019
- IDN-Owned Specialty Pharmacies May Face Challenges but Can Offer Distinct Benefits
- Infographic: Integrated Delivery Networks’ Impact Extends to PBM, Specialty Pharmacy Sectors
- New Gene Therapy to Treat SMA Comes With Unknowns
- Various Management Tactics Are Expected for Zolgensma
- What Forms of SMA Will Payers Approve Zolgensma Use for?
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CBO Says Proposed Rule to Kill Rebates Will Increase Spending by $177 Billion
May 20th, 2019
- Program Helped Biosimilar Infliximabs Capture Market Share, Producing Savings
- IQVIA Institute Report Shows Biosimilar Uptake Continues to Rise
- Reality Check: COPD
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Administration Calls for Eradication of HIV, But Could HHS Proposal Undermine Effort?
April 1st, 2019
- Drugmakers Get Good PR Via Authorized Generics, but Other Effects Are Less Clear
- Medical Benefit Drug Spend, Efforts to Manage It Increase
- Infographic: Magellan Rx Report Shows Increases in Commercial, Medicare Drug Spending
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HHS Takes Aim at Rebates With Proposed Rule That Could Transform Pharma Industry
February 18th, 2019
- California’s Plan to Take Over Medi-Cal Pharmacy Benefit, Purchasing Makes Waves
- Infographic: California Medicaid Could Shift to Fee-for-Service Drug Benefit
- Reality Check: Crohn’s Disease
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HHS Proposes Loosening Restrictions on Protected Drug Classes, Other Changes
January 7th, 2019
- Payers Prepare for Cellular and Genetic Therapies’ Push Into Commercial Arena
- Global gene therapy market size, by indication, 2014-2026 (USD Million)
- FDA Approves Tissue-Agnostic Drug That Targets Rare Fusion