Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
The CDC estimates that more than 33,000 Americans are living with hemophilia, an inherited bleeding disorder which affects primarily men. Patients with hemophilia have a deficiency of the blood proteins, known as coagulation or clotting factors, that help blood to clot properly. The two most common subtypes are hemophilia A (factor VIII deficiency) and hemophilia B (factor IX deficiency).
While patients with mild hemophilia may have only sporadic episodes of uncontrolled bleeding, typically following injury or surgery, patients with severe hemophilia…
This article was originally published in Fierce Pharma.
In the realm of oncology, the advent of clinical pathways has gained substantial traction in the past two decades as the increasing cost and complexity of cancer care demanded structured, multidisciplinary, and cost-effective approaches. Pathways have become a critical strategy for both physicians and payers to streamline treatment decision-making, standardize evidence-based care, improve patient outcomes by minimizing unnecessary variation, and reduce cost by guiding care to the most cost-effective treatments. These pathways, often referred to…
For the past few years, the industry has grappled with the rise of a controversial new pharmacy benefits strategy: alternative funding. Alternative funding programs (AFPs), also known as specialty carve-out programs, are intended to reduce the cost of specialty drugs for both patients and payers.
According to proponents, AFPs can help employers improve access while keeping costs in line. But according to detractors, these programs are by nature unsustainable—and potentially illegal. Despite these concerns, AFPs have been on the rise. According…
This article was originally published in Pharmacy Times.
Amid a projected uptick in the prevalence of chronic diseases for an increasingly aging population, it’s more imperative than ever for patients to have access to the therapies they need to treat their health conditions. To improve patient access, stakeholders across the industry have turned to real-world data (RWD) to uncover critical insights into the patient journey—from social determinants of health to diagnoses, treatment, and outcomes.
With the Center for Drug Evaluation and Research…
Artificial Intelligence (AI) technology and ChatGPT are disrupting countless industries around the world. For healthcare, the possibilities appear promising, with organizations striving to improve patient outcomes and the overall quality of care. According to Precedence Research, AI in healthcare is expected to surpass $187.95 billion dollars by 2030, growing at a CAGR of 37% during the forecast period 2022 to 2030.
From pipeline to prescription, certain healthcare spaces have been quick to adopt AI technology. In the clinical setting, AI and…
From the spring of 2020 to March 2023, Medicaid gained approximately 20 million new members, thanks in large part to the provision for continuous enrollment during the pandemic. Once Medicaid eligibility redeterminations were officially back in play in April 2023, states were allowed to begin the process of disenrolling beneficiaries who failed to meet their program’s income requirements.
Now we’re seeing Medicaid enrollment plummet for the first time in years, while public health exchange plan enrollment is on the upswing. What…
In our last blog on this subject, we asked three clinical experts to explain how integrated real-world and market access data helps pharma companies go to market. In this blog, our experts weigh in on how integrated data helps pharma brands identify patients, correct payer/IDN misalignment, and make better predictions to improve patient care.
We hear a lot about the “whole picture” of market access. Can you explain? Lance Wolkenbrod, Sr. Director of Commercial Solutions, MMIT: Pharma companies basically have three…
When a manufacturer is at least a year out from a drug’s PDUFA date, the market access team begins to make informed decisions about what data is necessary for a successful launch. Many are using claims, lab, and other real-world data sets to access the right patient population at the right time to drive utilization of their therapies.
To explore why claims and lab data is so important for commercialization, we asked three clinical experts to explain the value of an…
Last year was a period of adjustment for the U.S. pharma industry, as the combination of increased financial pressures and the Inflation Reduction Act (IRA) meant adjustments to resource allocation. While concerns about macro trends like inflation and interest rates are still top of mind for manufacturers, we expect a renewed focus on efficient pipeline performance, portfolio growth, and innovative technology.
To better understand what 2024 might bring, I asked three of my colleagues to weigh in on upcoming shifts in…
As healthcare costs continue to climb, insurers are eager to control their spend. According to WTW’s Global Medical Trends Survey, 58% of insurers anticipate higher medical trend over the next three years. How stakeholders approach cost containment varies significantly depending on their priorities and incentives.
Payers, pharmacy benefit managers (PBMs) and employer benefit managers (EBMs) have varying relationships and responsibilities depending upon their level of risk and decision-making power. In some cases, payers are the final arbiter of member benefits, while…
