Thought Leadership

Artificial Intelligence (AI) technology and ChatGPT are disrupting countless industries around the world. For healthcare, the possibilities appear promising, with organizations striving to improve patient outcomes and the overall quality of care. According to Precedence Research, AI in healthcare is expected to surpass $187.95 billion dollars by 2030, growing at a CAGR of 37% during the forecast period 2022 to 2030.

From the spring of 2020 to March 2023, Medicaid gained approximately 20 million new members, thanks in large part to the provision for continuous enrollment during the pandemic. Once Medicaid eligibility redetermina...

In our last blog on this subject, we asked three clinical experts to explain how integrated real-world and market access data helps pharma companies go to market. In this blog, our experts weigh in on how integrated data helps pharma brands identify patients, correct payer/IDN misalignment, and make better predictions to improve patient care.

When a manufacturer is at least a year out from a drug’s PDUFA date, the market access team begins to make informed decisions about what data is necessary for a successful launch. Many are using claims, lab, and other real-world data sets to access the right patient population at the right time to drive utilization of their therapies.

Last year was a period of adjustment for the U.S. pharma industry, as the combination of increased financial pressures and the Inflation Reduction Act (IRA) meant adjustments to resource allocation. While concerns about macro trends like inflation and interest rates are still top of mind for manufacturers, we expect a renewed focus on efficient pipeline performance, portfolio growth, and innovative technology.

As healthcare costs continue to climb, insurers are eager to control their spend. According to WTW’s Global Medical Trends Survey, 58% of insurers anticipate higher medical trend over the next three years. How stakeholders approach cost containment varies significantly depending on their priorities and incentives.

In the past few years, it’s become more challenging for pharmaceutical companies to promote their products directly to healthcare providers (HCPs), and COVID only exacerbated this trend. Physicians are more selective in who they choose to meet with, and many no longer accept face-to-face meetings with pharmaceutical reps. According to 2023 research, more than 50% of physicians now meet with three or fewer pharma companies on a regular basis.

This has been a significant year for the Humira (adalimumab) biosimilar market. AbbVie's blockbuster drug Humira, an injectable used to treat a range of inflammatory conditions, saw the end of its 20-year, $200 billion monopoly in January. By the beginning of November, nine adalimumab biosimilars had made their market debut.

For decades, payers have used prior authorizations (PA) with the intent of curbing costs by preventing the unnecessary use of medical procedures or treatments. But in recent years, more and more physicians have contended that the practice impedes their ability to provide care.

In pharma, every year seems to bring forth even more change than the year before, but 2023 just might take the cake. Stakeholders have had to adjust to new developments in the healthcare ecosystem such as the Inflation Reduction Act, the rise of immunology biosimilars and insulin price changes impacting payer rebate economics, and the recent ruling that insurers can no longer implement copay accumulator adjustor programs, among many others.