Thought Leadership

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.

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.

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.

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.

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.

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.

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.

Dallas Mavericks owner and venture capitalist Mark Cuban is taking aim at drug prices with his discount prescription drugs startup, Mark Cuban Cost Plus Drug Company. However, payers are divided on whether they want to work with the company, according to new MMIT research. By leveraging direct sourcing, Cost Plus Drugs’ goal is to eliminate excessive markups on prescription drugs. Cost Plus’ online pharmacy sells directly to consumers, and the firm is registered as a pharmaceutical wholesaler with the FDA.

In an effort to lower the cost of specialty drugs, many payers have initiated site-of-care optimization strategies. By encouraging patients to receive therapies in more cost-effective settings — such as physician offices, infusion clinics, or at home — payers can reduce unnecessary expenses while ensuring members receive clinically appropriate care.

Even though we knew it was coming, the end of the COVID public health emergency (PHE) on May 11, 2023, still took the healthcare industry by surprise. While the end of the PHE resulted in the rollback of many COVID-19 programs, it also changed the ways that Medicare patients can access oral therapies from community oncology clinics.