The New Economics of Gene Therapy
Cell and gene therapies are no longer reserved only for ultra-rare diseases. In many therapeutic areas (TAs), advances in viral vector delivery, gene editing technologies, and cell-based medicine are enabling interventions that target disease at its biological source, often through a single administration rather than lifelong treatment. These developments should be unequivocally positive for patients. […]
From Prior Authorization to Clinical Pathways: The Growing Role of AI in Payer Strategy
There is no doubt that payers in the U.S. are investing heavily in AI, but there is much uncertainty about how this technology is currently deployed. While the industry’s AI conversation has focused on generative tools and administrative efficiency, payers are increasingly deploying AI in utilization management, clinical pathways and contracting. According to research from […]
The Evolving Payer Landscape for Early Detection Tests
In many therapeutic areas, especially oncology, physicians have been using early screening tests for decades. Designed to identify the early signs of a disease or condition before any noticeable symptoms develop, early detection tests support timely medical intervention. In the U.S. alone, early cancer screenings have been credited with preventing 4.75 million deaths (and counting) […]
Winning Payer Support for Rapid NGS Biomarker Testing in Oncology
Biomarker testing is a cornerstone of modern oncology, transforming how clinicians diagnose, stratify, and treat cancer. By identifying particular genetic, molecular, or protein characteristics in a patient’s tumor or blood sample, biomarker tests provide invaluable insights into disease behavior and a patient’s potential response to various therapies. In recent years, advances in next-generation sequencing (NGS) […]
You Only Launch Once: Five Ways to Reduce Market Access Risk
For many manufacturers, the period between FDA submission and the PDUFA date feels deceptively quiet. Clinical work is largely complete, pricing assumptions have already been modeled, and commercial teams are waiting for the green light. But in reality, this pre-launch window is one of the most consequential phases of a brand’s lifecycle—and one of the […]
From Compliance to Strategy: How Payers Are Refining Their IRA Playbooks
When the Inflation Reduction Act (IRA) first passed in late 2022, payers rushed to respond. On paper, the bill’s intentions were clear: this legislation sought to lower drug costs, reduce patients’ out‑of‑pocket burden, and empower Medicare to negotiate prices for the first time. In practice, however, the ripple effects have been far more complex for […]
Portfolio Contracting: The Power Move Reshaping Pharma Access
Portfolio contracting is quietly rewriting the rules of pharmaceutical market access. What began as a way to bundle a handful of related products has evolved into a defining access strategy that influences pricing, formulary positioning and competitive dynamics across therapeutic areas (TAs). Today, market success depends less on a single blockbuster drug than on how […]
Market Access in 2026: Predictions on Policies, Contracting and AI
To better understand what 2026 might bring, we asked three MMIT market access experts to share their perspectives on upcoming market shifts. Read the first of this two-part series for key insights into the year ahead. 1. What’s the biggest challenge for manufacturers launching new products this year? Steve Callahan, Senior Director, Advisory & Insights: […]
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 […]
Tracking the Real-World Impact of Payer Policies on Patient Outcomes
In today’s complex pharmaceutical landscape, a brand’s market access can no longer be judged solely by its coverage. Pharma leaders are under growing pressure not just to identify access barriers, but to prove their impact. They want the ability to link payer policy decisions to patient outcomes, as their payer strategies and competitive positioning depend […]