Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
This article was originally published in BioPharma Dive.
Many oncology manufacturers assume that a therapy’s inclusion on clinical pathways is more important than its coverage profile, but this isn’t always true. According to MMIT Pulse Analytics data, roughly 64% of U.S. oncologists are exposed to third-party clinical pathways developed either by an oncology group or a payer. However, a payer or PBM’s medical policies and formulary placement can also have a huge impact on a drug’s utilization.
Patient access can easily be blocked by…
Recently, payers have started to use the phrase “member disruption” to refer to the potential impact of an impending formulary change on their members. This qualitative term is mentioned with increasing frequency during contracting discussions and P&T sessions, although the weight of these considerations varies between organizations.
Member disruption describes the impact of formulary changes across three spectrums: how a plan is perceived by both members and employers; the workload and logistics required for a payer to execute a change; and…
In the wake of the COVID-19 pandemic, drug shortages, caused by increased demand, supply chain difficulties, and supplier issues have plagued payers and patients alike, making it harder for patients to access the therapies they need and causing delays in treatment. Drug shortages hit a record five-year high in 2022, according to a U.S. Senate report.
To learn more, in August we asked payers about the impact and challenges they face due to drug shortages, focusing on ADHD therapy and chemotherapy…
This article was originally published in Drug Channels.
Over the past two decades, skyrocketing list prices for insulin have threatened medication adherence for the estimated 7.4 million American diabetics who rely on insulin to manage their disease. According to the American Diabetes Association, nearly one in four insulin-dependent diabetics have decreased or skipped doses because they could not afford to maintain their regimen.
With the passing of the Inflation Reduction Act of 2022, Congress addressed the financial strain on nearly three million diabetics…
This article was originally published in STAT.
For manufacturers, building a static commercialization strategy will only take you so far. But infusing that strategy with real-world data (RWD) — consisting of medical claims, lab testing and pharmacy data, and electronic health records — provides a more holistic view of the patient journey.
RWD fills in crucial missing puzzle pieces, especially when it’s integrated alongside payer coverage data. It can show if a patient is unable to access a drug and why — insights…
Respiratory syncytial virus (RSV) can impact anyone, but infants and older adults are most at risk of illness. With multiple new immunizing agents gaining FDA approval in 2023—and more in the pipeline—manufacturers and payers have a role to play in educating patients and providers about the importance of immunizations to combat RSV.
RSV, a contagious virus that can cause severe illness or death, is a common cause of respiratory illness. According to the U.S. Centers for Disease Control and Prevention (CDC),…
For manufacturers, the success of a new brand hinges on its uptake in the first few months after launch. Many pharma companies are surprised to realize that payer coverage is more limited than anticipated, especially in highly competitive markets. A poor launch can quickly lead to a disappointing performance trajectory.
To predict payer behavior with accuracy, many manufacturers analyze analogous market access scenarios to better anticipate the payer policies that might apply to their therapy. Analog analyses can reveal the details…
Ever since the Inflation Reduction Act (IRA) became law, pharma companies have struggled to identify how these changes will affect their business. In many ways, the IRA is forcing a marriage of necessity between product development and market access, as manufacturers must now be more focused on anticipating future market states for their potential and existing pipeline.
In our last IRA Q&A blog, we focused on the Medicare Drug Negotiation Program. Today, we’ll focus on the overall impact of the IRA,…
Since the passing of the Inflation Reduction Act (IRA) last fall, pharma companies have been bracing for the impact of its provisions. The main healthcare-related IRA policies are the out-of-pocket spending cap, the Medicare Drug Price Negotiation Program, and the penalty for increasing drug prices faster than inflation.
To get a better sense of what a post-IRA future might look like, we asked two MMIT experts to weigh in on the questions our clients are asking. In this blog, we’ll focus…
In the past few years, real-world data (RWD) has become an increasingly important element of a successful market access strategy. By blending claims and lab data with clinical pathway and payer coverage data, pharma companies can get full visibility into what’s happening in the market.
But how, exactly? What can a unified source of RWD reveal about the patient journey? And, most importantly, how can manufacturers use those insights to expand patient access to their therapies? The key to harnessing RWD…
