Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
The use of alternative funding programs (AFP) has been on the rise in recent years, in keeping with the growing number of self-funded employer health plans. Run by for-profit vendors, AFPs are a relatively new type of specialty carve-out program meant to save employers money by removing certain high-cost medications from their formularies.
Instead of filing with their health plan, AFP vendors encourage patients to apply for financial assistance through pharma patient assistance programs (PAPs) or charities. AFPs have serious consequences…
Our latest research at Norstella strongly suggests that a highly dynamic market access situation in the U.S. is feeding back into upstream decisions around R&D strategy. We explored this topic in detail in a recent white paper, Working Backwards: Patient Access Strategy Is Now Guiding R&D. This article briefly summarizes the first half of the report.
From compressed drug lifecycles to therapeutic area priorities, drug developers are resetting as the status quo shifts. Policymakers are looking to wield greater control over…
In today’s complex pharmaceutical landscape, a brand’s market access can no longer be judged solely by its coverage. Pharma leaders are under growing pressure not just to identify access barriers, but to prove their impact. They want the ability to link payer policy decisions to patient outcomes, as their payer strategies and competitive positioning depend upon this kind of actionable intelligence.
This shift in focus demands a new level of visibility across the healthcare ecosystem, as market access teams often struggle…
Every day, patients are experiencing the life-changing impact of real-world data (RWD), and life sciences companies are feeling the business impact, too.
RWD is no doubt helping pharma companies better understand the patient journey and get life-saving therapies to market faster, according to Norstella’s recent survey of 200 life science executives. Over the next one to three years, RWD will play a key role for life sciences, with 40% of the executives we surveyed rating it “critical” and 58% rating it…
In July 2025, the 2025 Federal Budget Reconciliation bill, known colloquially as the One Big Beautiful Bill Act (OBBBA) and officially as H.R.1, was signed into law.
This act introduced major, immediate reforms to Medicaid, adding new administrative requirements and eligibility conditions (including work requirements) for patients seeking to enroll in or maintain Medicaid coverage. It also lowered the cap on state-directed payments—the supplemental payments states pay to increase reimbursement rates for specific providers that serve a large number of Medicaid…
Urinary tract infections (UTIs) rank as the most common bacterial infection for women worldwide. Between 50-60% of adult women experience at least one UTI in their lifetime, and approximately 25% of them suffer recurring infections, defined as two or more episodes within six months. As the prevalence of recurring infection increases with age, older women are more likely to be plagued with frequent UTIs.
The primary treatment for uncomplicated UTIs is a short regimen of one of several broad-spectrum antibiotics. Unfortunately,…
As patient access grows more complex, manufacturers need tools that reduce friction throughout the care journey. One valuable but frequently overlooked dataset is known as BIN/PCN/Group (BPG) data, which refers to a trio of identifiers used in pharmacy claims processing.
Unlocking the power of BPG data can transform claims bridging and streamline early benefit verification, helping pharma companies provide support to more patients in need.
What Is BPG Data, and Why Is It Elusive? A patient’s drug benefit insurance card features…
The oncology market is growing rapidly, driven by advancements in diagnostic technology, new biomarker testing, and a wealth of targeted therapies. The non-small cell lung cancer (NSCLC) space is especially crowded, which should be good news for the 226,000 patients diagnosed with this disease each year.
Despite the new developments in NSCLC treatment, however, many challenges persist—along with a few new roadblocks. Both payers and oncologists still perceive high unmet need in this space, from a lack of effective drugs to…
As medicine evolves, even smaller therapeutic areas are impacted by scientific breakthroughs and novel technologies, leading to an eruption of new therapies. Hereditary angioedema (HAE), a rare genetic disorder affecting 1 in 50,000 people worldwide, is the latest indication to reap the benefits of several new market entrants.
Due to a deficiency of the C1 inhibitor protein, HAE patients experience recurrent episodes of severe swelling in various parts of the body, most commonly the face, throat, limbs, and intestinal tract. Individuals…
For pharma manufacturers, securing expedited approval for a drug in development is typically seen as a win, which will result in faster patient access as well as faster revenue recognition. However, the realities of market access mean that drugs approved by expedited pathways—most notably, the accelerated approval pathway—may face a much more difficult path to coverage and provider uptake.
The use of FDA expedited approval pathways has grown significantly in the past two decades, and expedited approval of one sort or…
