Using Real-World Data to Improve Patient Access to Oncology Therapies
This article was originally published in BioPharma Dive. Many oncology manufacturers assume that a therapy’s inclusion on clinical pathways is more important than its coverage profile, but this isn’t always true. According to MMIT Pulse Analytics data, roughly 64% of U.S. oncologists are exposed to third-party clinical pathways developed either by an oncology group or a payer. However, […]
How Are Payers Responding to ADHD and Chemo Drug Shortages?
In the wake of the COVID-19 pandemic, drug shortages, caused by increased demand, supply chain difficulties, and supplier issues have plagued payers and patients alike, making it harder for patients to access the therapies they need and causing delays in treatment. Drug shortages hit a record five-year high in 2022, according to a U.S. Senate […]
Uncovering the Patient Journey: Four Ways that Real-World Data Offers Value
This article was originally published in STAT. 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. RWD fills in crucial missing […]
10 Questions Oncology Manufacturers Should Be Asking About the Stark Law
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 […]
Driving Market Access for Rare Disease Therapies
In the past, rare disease manufacturers often assumed that any therapy they launched would automatically be covered by most health plans. But the rising cost of many rare disease drugs has increased payer sensitivity to the expense of these therapies, even those with orphan drug designation. Many rare disease treatments are placed in the highest […]
What’s Ahead for Market Access in 2023?
Despite the challenges of the pandemic, the pharma industry has enjoyed steady growth during the past two years, which is expected to continue in 2023. The global pharmaceutical market is forecast to expand at a CAGR of 5.7% between now and 2028. Hundreds of products are currently awaiting FDA approval, and new modalities, including cell […]
Payers and PBMs Are Excluding Cancer Drugs at a Growing Rate. How Can Manufacturers Prepare?
With rebates now a common pharma practice, and generics and biosimilars launching in oncology, payer management of once-untouchable cancer drugs is growing. As the FDA continues to approve a large number of cancer drugs, resulting in increased competition in various tumor types, and spending on these agents continues to rise, PBM and payer formularies are […]
Manufacturers: Are You Familiar With Payers’ Genetic Testing Coverage Procedures?
As researchers continue to identify specific genetic markers within different diseases, more and more treatments targeting those markers are launching. In fact, more than 77,000 genetic tests currently are available. They can identify, for example, what type of breast cancer or non-small cell lung cancer a patient has. Some can determine a person’s risk for […]
Five Reasons You Can’t Ignore Payers During Pipeline Development
Could previously launched drugs that significantly missed sales expectations have met a different fate if their manufacturers had accounted for payer perspectives in their early stage development strategy? Let’s start with some stats. About half of the drugs launched in the last 15 years underperformed analysts’ sales estimates by more than 20% Only one-fifth of […]
Are Clinical Pathways Expanding Beyond Oncology?
In oncology, clinical pathways—recommendations of specific treatments for a specified group of patients—have long been used to help control costs and treatment variation while improving outcomes. Clinical pathways may be payer-driven or provider-driven based on the organization that develops and controls the pathways, and financial incentives and policing mechanisms encourage provider buy-in and adherence. While […]