Thought Leadership

Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends

Industry Trends

Market Research Insights: How to Get the Data You Need from Payer Decision Makers

Market access research leverages the knowledge of influential members of payer organizations to illuminate existing and potential barriers to access. Payer decision makers can provide invaluable insights into a payer’s preferences, purchasing behaviors, and trends, as well as regulatory and policy issues that may need to be addressed. Manufacturers’ market

How Real-World Data Helps Manufacturers See the Complete Market Access Story

In competitive therapeutic areas, like immunology and oncology, optimizing market share depends on creating a more structured, holistic market access story. By augmenting traditional market access datasets with real-world data from claims and labs, manufacturers can follow patients’ progression along the care continuum—and uncover new opportunities to improve access. Understanding

How Can Pharma Use Data-Driven Frameworks to Ensure Commercial Success?

Biotech and pharma companies have a vast range of capabilities and data sophistication, from their data acquisition strategy down to the way they consume, curate and present data internally. In the last 10 years of my career, I’ve been involved in hundreds of data assessments on the side of the

Coping With Drug Shortages: How Payers and Manufacturers Can Support Continued Patient Access

The COVID-19 pandemic illuminated a challenge to the U.S. healthcare system that continues to undermine effective patient care: medication shortages.  A Senate report found that drug shortages increased nearly 30% last year, with a record five-year high of 295 active drug shortages by the end of 2022. Most recently, these

Spotlight on Vaccines: The Inflation Reduction Act’s Impact on Coverage

While the Inflation Reduction Act (IRA) may best be known for mandating Medicare drug price negotiation, the act did much more than that. Among its other accomplishments are the elimination of cost sharing for vaccines under Medicare Part D, as well as improved access to adult vaccines for Medicaid and

Key Trends in Medical Benefit Contracting

The rising cost of specialty pharmaceuticals has motivated payers to implement tighter restrictions and seek both traditional and value-based contracts. As manufacturers are already contracting with GPOs, distribution networks and medical practices, most would prefer to avoid contracting with payers and PBMs for their medical benefit products. Yet the data

Weighing the Benefits: Are Payers Likely to Cover Weight Loss Drugs in 2023?

In 2021, Novo Nordisk’s Wegovy (semaglutide) gained FDA approval for chronic weight management in overweight or obese adults, hitting the market in June 2022 at a list price of $1,349 per 28-day supply. In clinical trials, patients achieved an astounding mean weight loss of nearly 15% after 68 weeks of

Removing Access Barriers for Long-Acting Injectables

The past few years have seen an increase in the number of long-acting injectable (LAI) therapies for a variety of disorders and diseases, including schizophrenia, bipolar disorder, and HIV. These LAI antipsychotics and antiretroviral therapies include brand-name drugs such as Invega Sustenna (paliperidone palmitate by Jannsen), Abilify Maintena (aripirazole by

Unintended Consequences of the IRA: Will the CPI Penalty Increase the Price of Drugs?

The Inflation Reduction Act (IRA), signed into law in August 2022, was intended in part to lower healthcare costs for families and small businesses. The IRA contains several provisions aimed at prescription drug costs which will roll out over the next few years, with the earliest taking effect this year.

Staying Competitive in an Expanding Medicare Advantage Market

Over the past year, the health plan landscape has seen significant enrollment shifts, especially within government-sponsored plans. According to MMIT’s Directory of Health Plans, the top 10 Medicare Advantage insurers accounted for 77.2% of the national market at the close of 2022. Nine of the top 10 organizations reported year-over-year