Prepping for the Inflation Reduction Act: Why Manufacturers Need a Plan for Rapid RWE Generation
Since the passing of the Inflation Reduction Act (IRA) in August 2022, the healthcare industry has been bracing for the impact of several key provisions. Three of these policies—price negotiations, inflation-adjusted rebates, and the out-of-pocket spending cap—will be at least partially in place by the close of 2023. As manufacturers prepare for the effects of […]
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 access teams can optimize access […]
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 access functions in reality […]
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 data supplier. Regardless of an […]
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 shortages include drugs used to […]
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 Children’s Health Insurance Program (CHIP) […]
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 reveals that medical benefit contracting […]
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 treatment with Wegovy. Excess body […]
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 Otsuka), and Cabenuva (cabotegravir/rilpirivine 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. As of 2023, CMS will […]