Market Access 101: Securing Coverage Under the Medical Benefit
Welcome back to MMIT’s Market Access 101 blog series. Our first post, Understanding the Basics, covered the difference between the pharmacy and medical benefit structure, while our second, Improving Your Drug’s Formulary Placement, discussed how to overcome access barriers. In this post, we’ll discuss what manufacturers should know about drugs covered under the medical benefit. […]
Market Access 101: Improving Your Drug’s Formulary Placement
Welcome back to MMIT’s Market Access 101 series, in which we unpack the complexities of market access via a series of blog posts. In our first post, Understanding the Basics, we covered the difference between the pharmacy and medical benefit structure, the typical timeline for drug review, and why it’s critical to determine which entity […]
What Payers Want: Understanding Payer Preferences When Evaluating Therapies
Many manufacturers are interested in which factors can give them an edge on obtaining preferred coverage with payers. This is especially true given the increasing competition in saturated categories such as immunology, diabetes care and breast cancer. We scoured recent MMIT research to gain a better grasp on the factors that are top of mind […]
Market Access 101: Understanding the Basics
For many pharmaceutical companies, planning for commercialization only begins in earnest when a drug has been submitted for FDA approval—which is far too late. Ideally, a company’s commercial and market access teams should be fully functional long before the approval stage, as many decisions must be made in the early phases of the drug development […]
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 […]
To Ace Your Product Launch, Don’t Fail At Market Access
Imagine that it’s senior year of high school, and you show up to chemistry class completely unprepared for the midterm exam—a midterm that’s worth half of your grade. Instead of studying the periodic table, you spent the previous evening rehearsing your choir solo. And while extracurriculars are important, messing up a few lyrics during the […]
From Buy-and-Bill to White Bagging: The Future of Reimbursement Under the Medical Benefit
Pharmaceutical manufacturers that are nearing the commercialization stage of pre-approval planning are faced with a lot of realities about managed markets. Manufacturers are so engrossed in the details of a clinical trial, and its eventual success, that beginning to plan for commercialization can be daunting. However, for physician-administered therapies or IV therapies, understanding and navigating […]
Why Pharma Companies Need a Strategy to Track Market Access in Real-Time
With payer coverage decisions around pharmaceuticals changing rapidly, simply being covered is no longer enough for getting patients on therapy quickly. Today, increasing market complexity and outsize payer influence have resulted in numerous hurdles to ensuring adequate access, from prior authorizations to step therapy to label restrictions. To succeed at launch amid these higher stakes […]