Alternative Funding Programs: Short-Term Savings, Long-Term Consequences
The use of alternative funding programs (AFP) has been on the rise in recent years, in keeping with the growing number of self-funded employer health plans. Run by for-profit vendors, AFPs are a relatively new type of specialty carve-out program meant to save employers money by removing certain high-cost medications from their formularies. Instead of […]
The R&D Implications of Market Access Complexity
Our latest research at Norstella strongly suggests that a highly dynamic market access situation in the U.S. is feeding back into upstream decisions around R&D strategy. We explored this topic in detail in a recent white paper, Working Backwards: Patient Access Strategy Is Now Guiding R&D. This article briefly summarizes the first half of the […]
GenAI and RWD in Pharma: 4 Questions to Fuel Effective Insights
Generative AI (GenAI) has become one of the most talked-about innovations in healthcare analytics, but for life sciences organizations, simply deploying an AI-powered solution is not enough. To truly unlock the power of real-world data (RWD), GenAI must go beyond checking a box or riding the latest buzzword wave. It should provide a guided, intuitive […]
How PBMs Are Reshaping Biosimilar Market Access
As biosimilars continue to redefine the specialty drug landscape, payers and their associated pharmacy benefit managers (PBMs) are executing new strategies to capture a larger share of revenue. PBMs are partnering with manufacturers to co-develop and commercialize their own private-labeled biosimilar products. This coordinated approach provides value to both parties, as it enables them to […]
Apples to Apples: Stelara Biosimilars and the Fight for Market Share
Over the next five years, 88 biologics—including several blockbuster agents like Eliquis, Keytruda, Opdivo, and Darzalex—are facing a loss of exclusivity, representing an estimated market of more than $100 billion. After the fierce competition between Humira (adalimumab) biosimilars, manufacturers are keeping a close eye on adoption dynamics for biosimilars of Johnson & Johnson’s autoimmune drug, […]
Quantifying Value: Innovative Contracting for High-Cost Drugs
As high-cost specialty treatments become more common, manufacturers are turning to innovative contracting to boost coverage for their products. Many cell and gene therapies, orphan drugs, and oncology therapies are prohibitively expensive, with costs ranging from several hundred thousand to millions of dollars. Warranty-based agreements help mitigate the risk of paying for these therapies, as […]
The Rise in Biotech Commercialization
In 2024, biotechs were behind almost two-thirds of the FDA’s new drug approvals. Many biotechs are choosing to commercialize their products themselves, rather than partnering with Big Pharma players. Many fail, but some market factors are now in biotech’s favor. A recent Evaluate report, Going Solo: Commercializing Biotech, analyzes the dynamics that are enabling biotech […]
Selling the Script: The Introduction of Private Equity in Retail Pharmacy
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 […]
Asembia Trends: IRA Operationalization and the Future of Specialty Therapies
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 […]
Patient Access Barriers in 2025 and Beyond
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 […]