Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
As the 340B Drug Pricing Program continues to grow in size and importance, its operations are being scrutinized more than ever. Pharma manufacturers, who have long noted issues with this program, have made various attempts at reform.
Their latest strategy — which would move away from up-front discounts to a rebate model — is currently in limbo as the courts weigh in. If drugmakers are successful in their efforts, however, findings from a recent MMIT survey indicate they would be advised…
Over the past decade, health systems have seen a rapid influx of private equity, with a six-fold increase in acquisitions totaling $10 trillion. As private equity firms continue to explore new methods of investment in health care, the recent announcement that Walgreens Boots Alliance will be acquired by Sycamore Partners seems to be a natural progression in strategy.
What does the introduction of private equity into one of the largest pharmacy chains in the U.S. mean for the industry? While this…
To speed patient access to potentially life-saving therapies, the FDA established expedited approval pathways for selected drugs that fill unmet needs or treat serious conditions. For patients in need, these pathways serve an essential purpose. But many payers and providers are concerned that expedited pathways do not require sufficient safety and efficacy data.
Their concerns impact coverage decisions, reimbursement models, and ultimately, patient access. The four key approval pathways are as follows:
Fast track: Manufacturers apply for this designation, which is…
At the end of April, more than 8,000 attendees visited Las Vegas for the Asembia Specialty Pharmacy Summit, otherwise known as AXS25. If you missed the conference, here’s an overview of some of the key areas covered this year:
Keeping an Eye on Government Policies AXS25 featured quite a few presentations on the impact of the new administration on pharma, from a session on What Pharma Must Know About Tariffs, Supply Chains, and Policy Changes to one entitled How the Next 90…
The landscape of patient access has become increasingly complex, intensified by evolving channel dynamics, greater biosimilar investment, and legislative reform. As payers evolve their utilization management tactics, manufacturers must also become more sophisticated in their access strategies.
To explore these topics, MMIT and The Dedham Group conducted the second annual State of Patient Access Survey to collect insights from 250+ pharmaceutical and biotech executives focused on market access and brand strategy. Let’s take a look at a few of our findings.
Established by the Inflation Reduction Act in August 2022, the Medicare Drug Price Negotiation Program is still in its infancy, but is expected to impact a wide swath of stakeholders in the U.S. healthcare system. Last year, CMS negotiated prices for the first round of drugs, and in January, the agency revealed its second list of drugs that will be subject to negotiations this year.
All manufacturers — not just those with drugs on the list — should strategize based on…
This article was originally published in BioPharma Dive.
Pharma companies are increasingly turning to real-world data to answer their commercial business questions, but not all realize that unstructured EMR data is the unsung hero of most queries. Whether a manufacturer is struggling to find a niche patient population, conduct unbiased outcomes research, or generate persuasive proof points, unstructured data can fill in the gaps left by other real-world data sources.
Until recently, this valuable information has been virtually impossible to analyze at scale.…
In a recent post on specialty carve-out mechanisms, we examined how payers’ use of specialty benefit managers and alternative funding programs can impact manufacturers’ patient assistance programs (PAPs). Today’s post takes a look at another managed care trend: the rise of copay accumulators and maximizers, also known as copay adjustment programs.
In 2025, copay accumulator and maximizer programs have become one of payers’ primary strategies for mitigating the use of PAPs. While these controversial programs help payers fully leverage the funds…
Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed condition affecting millions worldwide. People with OSA are subject to sudden drops in blood oxygenation levels that can lead to severe cardiovascular, metabolic, and cognitive consequences if the condition remains untreated. Traditionally, OSA has been managed through personal appliances that apply continuous positive airway pressure (CPAP). Although CPAP machines are considered the gold standard of care, patient adherence remains a major challenge due to their relative discomfort and inconvenience.
Oral appliances, such…
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…
