Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
Navigating the landscape of patient access in the pharma industry has become increasingly complex, extending far beyond traditional channels. The challenges are multifaceted, influenced by evolving policies, innovative payer strategies, and shifts in provider dynamics.
Recent market research conducted by MMIT and The Dedham Group, encompassing insights from more than 300 industry stakeholders, sheds light on the critical barriers to patient access that are top of mind for pharma executives. Let’s take a look at the results of our survey:
1.…
This article was originally published in Drug Channels.
Despite the rapid evolution of personalized medicine, access to genetic testing and next-generation sequencing (NGS) is a challenge—due in no small part to coverage confusion. Physicians struggle to navigate poorly defined testing coverage policies and a fragmented payer and vendor ecosystem, resulting in delayed care for patients requiring precision therapies.
Biomarker testing and NGS are more likely to be covered by payers if markers are associated with targeted therapies (i.e., biomarker-specific language in…
The hypertension market is no stranger to new entrants, with therapies ranging from calcium channel blockers and angiotensin II receptor blockers (ARBs) to angiotensin-converting enzyme (ACE) inhibitors and beta blockers. As a mature market, generics are widely available, and many of the more recently approved therapies are combinations of existing agents or different formulations of FDA-approved treatments.
So in a market with long-established therapies and plenty of branded and generic competition, do new market entrants stand a chance? And what does…
Consideration of patients’ social determinants of health (SDoH) has been a facet of healthcare delivery in the United States for decades. The CDC defines SDoH as the nonmedical factors that influence a patient’s health outcomes, such as access to care services and medication, housing and food stability, education levels, and employment.
During the COVID-19 pandemic, SDoH became a more prominent area of focus for providers and insurers, as inequities in access to healthcare became more apparent. Most healthcare professionals have an…
When it comes to the degree of payer management within a therapeutic area, pharma companies are becoming the victim of their own successes. One prime example is the rapid growth of competitive therapies across tumor types, pharmacological classes, and mechanisms of action in oncology. Payers have responded to the launch of more innovative and highly effective therapies with increased utilization management restrictions to balance the cost and quality of care.
Traditionally, the oncology space has been subjected to minimal management from…
It has now been over a year since the first Humira biosimilar, Amgen's Amjevita, entered the U.S. market. Eight additional adalimumab biosimilars followed suit, offering lower-cost alternatives to AbbVie’s blockbuster drug via a variety of dual-pricing and discounting strategies.
Some PBMs, including Express Scripts and Optum Rx, were quick to add some biosimilars to their formularies, embracing a mix of low-list-price and high-list-price/high-rebate biosimilars. Many other payers, however, have been somewhat slow to place biosimilars on their formularies, both within the…
In our collective experience working with dozens of clients, we’ve found that smaller pharma companies and biotechs wrestle with many common challenges, regardless of their therapeutic area. From limited budgets to a late start on market access activities, we see the same roadblocks time and again.
Here are four tips for smaller manufacturers on how you might approach the journey to commercialization—and come out ahead, despite the obstacles.
1. Get an early start on commercialization Small-sized pharma companies do not usually…
Manufacturers are continuing to wrestle with the effects of the Inflation Reduction Act (IRA) on their business plans and revenue streams. Although some of the IRA’s impacts are still uncertain, real-world evidence (RWE) is an important tool for manufacturers navigating the road ahead, as it will help them demonstrate the value and comparative effectiveness of their treatments.
One of the IRA’s requirements is the Medicare Drug Price Negotiation Program, which allows Medicare to negotiate the prices of certain high-cost, single source drugs without…
The category of treatments known as ‘digital therapeutics’ is widely misunderstood. Though the term is often conflated with ‘digital health’ tools, such as fitness trackers or meditation apps, digital therapeutics (DTx) are distinguished by their reliance on clinical evidence.
DTx products use evidence-based, clinically evaluated software to deliver medical interventions directly to patients to prevent, manage, or treat a disorder or disease. Many prescription digital therapeutics (PDTs) are software-only, while some are connected to wearable devices, and others are paired with…
This article was originally published in PharmaVoice.
Many years ago, I became one of the first people to be diagnosed with an ultra-rare vasculitis syndrome, a dangerous inflammation of the small blood vessels. My disease is so rare that I had a much better chance of winning the lottery, but instead, I ended up sick. The story of how I was finally diagnosed is as unlikely as my disease, but it also speaks to a few broader truths about the importance…
