Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
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…
In the past few years, it’s become more challenging for pharmaceutical companies to promote their products directly to healthcare providers (HCPs), and COVID only exacerbated this trend. Physicians are more selective in who they choose to meet with, and many no longer accept face-to-face meetings with pharmaceutical reps. According to 2023 research, more than 50% of physicians now meet with three or fewer pharma companies on a regular basis.
At the same time, physicians are still eager to know more about…
This has been a significant year for the Humira (adalimumab) biosimilar market. AbbVie's blockbuster drug Humira, an injectable used to treat a range of inflammatory conditions, saw the end of its 20-year, $200 billion monopoly in January. By the beginning of November, nine adalimumab biosimilars had made their market debut.
Pharma manufacturers have been closely following the adalimumab rollout, as this year serves as a case study for biosimilars yet to be approved. At the center of the discussion is a…
For decades, payers have used prior authorizations (PA) with the intent of curbing costs by preventing the unnecessary use of medical procedures or treatments. But in recent years, more and more physicians have contended that the practice impedes their ability to provide care.
Amid pushback from provider groups and a swell of state and federal legislation aimed at PA reform, payers are reevaluating the need for PA for certain drugs and services, particularly those with a high PA approval rate. Throughout…
This article was originally published on Drug Channels.
In pharma, every year seems to bring forth even more change than the year before, but 2023 just might take the cake. Stakeholders have had to adjust to new developments in the healthcare ecosystem such as the Inflation Reduction Act, the rise of immunology biosimilars, insulin price changes impacting payer rebate economics, and the recent ruling that insurers can no longer implement copay accumulator adjustor programs, among many others.
Over the next few years, several…
When a pharma company secures expedited approval for a drug in development, everyone involved is usually thrilled. After all, a faster approval process means that patients in need will be able to access this critical treatment more quickly. Manufacturers also assume that expedited approval will lead to faster revenue recognition, but this isn’t always true.
Many payers are reluctant to cover drugs approved via an expedited process due to insufficient safety and efficacy data. For drugs granted conditional approval, payers are…
Due to the end of the public health emergency for COVID-19 and subsequent redeterminations for Medicaid, health plan enrollment data has become increasingly volatile.
As of this spring, states were able to resume Medicaid eligibility redeterminations, which were stopped during the pandemic. For three years, states couldn’t check members’ income to determine whether they were still under the income limits for Medicaid in their states, which caused Medicaid membership to increase steadily throughout the pandemic, particularly in the first year, when…
The explosion of real-world data (RWD) now available to pharma companies can be overwhelming. While many larger manufacturers with their own teams of data analysts have been using RWD for years, smaller manufacturers are just beginning to incorporate RWD into their clinical development and market access strategies. Which data sets do they need, and how can they use them most effectively?
As the majority of pharma companies don’t have the resources to invest millions in a data lake, they’re looking for…
