Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
As therapies have become more complex, pharma companies are now challenged to achieve precision targeting within a much tighter timeframe. While claims data is readily available, one of its key limitations is the lack of timeliness.
Many manufacturers now rely on specialized lab data—from imaging results to genetic testing and genomics—to identify eligible patients and their providers. As lab data is often the key driver in diagnostic decisions, this is an excellent source for commercial targeting initiatives. But what about understanding…
Approximately 6.9 million Americans aged 65 and older have been diagnosed with Alzheimer’s disease (AD). By 2060, prevalence could reach 13.8 million if no therapies are approved to prevent or cure AD.
For decades, Alzheimer’s treatment focused on symptom management, with stagnant progress in experimental breakthroughs. That changed recently with the development of beta-amyloid targeting therapies. Although these disease-modifying drugs are not a cure for AD, they do remove beta-amyloid buildup in the brain, a promising yet still debated approach to…
Months and months of market access planning occur long before a new therapy is approved. Once that therapy is finally on the market, pharma companies must then turn their attention to the art of effective brand promotion.
While the first step is identifying the right prescribing physicians, how manufacturers engage with these HCPs is equally important. In today’s market, pharma companies need to adopt a coordinated, omni-channel approach to ensure prescribers fully understand their brand’s value.
With the right tools and…
For years, pharma commercialization strategies focused only on traditional market access data: payer policies and restrictions. While payer coverage is still essential information, this single-source approach cannot help manufacturers identify the many barriers to access. In the path to treatment, there are so many hurdles that can stand in the way of a patient receiving the right therapy, from referral delays to misdiagnosis, incomplete testing to payer behavior—the list is exhaustive.
To uncover and resolve these barriers, manufacturers need real-world data…
Payers tend to manage high-cost, high-complexity disease states quite differently than other indications. In recent years, payers’ growing reliance on managed care carveouts, in the form of specialty benefit managers (SBMs) and alternative funding programs (AFPs), has directly impacted pharma companies that offer patient assistance. This year, the downstream effects of the Inflation Reduction Act (IRA) and changes to Medicare Part D benefit will also play a role in patient access.
For pharma companies that offer a patient assistance program (PAP),…
As of 2024, more than 54 million Medicare beneficiaries had prescription drug coverage through Medicare Part D. Of that total, 31 million had Part D coverage alongside a Medicare Advantage plan, and about 23 million had a Part D prescription drug plan.
As a result of the Inflation Reduction Act (IRA), significant changes to the Part D benefit will take effect in 2025. Changes include a reduced out-of-pocket maximum, elimination of the coverage gap, continued drug price negotiations for selected therapies,…
The progressive integration of AI within medicine is transforming the way physicians evaluate and monitor disease, enabling earlier detection and improving outcomes and quality of care. Medical practices are increasingly leveraging datasets, algorithms, and other machine learning techniques to identify subtle patterns that might not be discernable to physicians without this technology.
These AI tools are especially useful in detecting conditions like early-stage cancer, cardiovascular diseases, and neurological disorders. For example, AI can analyze imaging data, such as CT and MRI…
Patients have expanding options for where to receive and take their medications. Both payers and manufacturers can capitalize on these options to improve patient access, adherence, and outcomes.
Within many therapeutic areas (TAs), medications that were previously covered by the medical benefit are now covered by the pharmacy benefit. To accommodate the new benefit designs, payer preferences regarding sites of care and routes of administration are also shifting. These changes have allowed payers to better control specialty drug spending.
Traditionally, patients…
The past few years saw the launch of several direct-to-consumer (DTC) programs, including Amazon One Medical and Mark Cuban’s Cost Plus Drugs. In 2024, several manufacturer-designed DTC programs, such as LillyDirect and PfizerForAll, have been added to the mix, demonstrating pharma’s continuing shift toward an integrated model of patient care.
While these programs can benefit multiple stakeholders, pharma companies should be aware of the existing and potential challenges before rolling out such a program.
Multiple Benefits for Stakeholders Patients stand to…
The weeks preceding a pharma product’s launch date are a critical window for market access teams. The ability to pivot and adjust to last-minute shifts can make all the difference between a successful first year and a disappointing launch trajectory. While much of your market access research may have already been completed by the time you go to market, there are several ways your team can continue impacting coverage and utilization.
Our first post in this series discussed the benefits of…
