What to Watch in Second Round of Medicare Drug Price Negotiations
Established by the Inflation Reduction Act in August 2022, the Medicare Drug Price Negotiation Program is still in its infancy, but is expected to impact a wide swath of stakeholders in the U.S. healthcare system. Last year, CMS negotiated prices for the first round of drugs, and in January, the agency revealed its second list […]
Alzheimer’s Drugs Face Uncommon Market Access Challenges
Approximately 6.9 million Americans aged 65 and older have been diagnosed with Alzheimer’s disease (AD). By 2060, prevalence could reach 13.8 million if no therapies are approved to prevent or cure AD. For decades, Alzheimer’s treatment focused on symptom management, with stagnant progress in experimental breakthroughs. That changed recently with the development of beta-amyloid targeting […]
Payers Prepare for 2025 Medicare Part D Changes
As of 2024, more than 54 million Medicare beneficiaries had prescription drug coverage through Medicare Part D. Of that total, 31 million had Part D coverage alongside a Medicare Advantage plan, and about 23 million had a Part D prescription drug plan. As a result of the Inflation Reduction Act (IRA), significant changes to the […]
What’s Ahead for Market Access in 2025?
As the pharma industry continues to adjust to the provisions of the Inflation Reduction Act (IRA), the country will soon be ushering in a new presidential administration—leaving the future of the IRA in question. Despite ongoing regulatory uncertainty, manufacturers will still be focused on the same concerns: drug development, pipeline performance and ensuring patient access […]
Accessing Weight-Loss GLP-1s: The Role of Compounding Pharmacies
Initially developed to manage type 2 diabetes, glucagon-like peptide-1 (GLP-1) agonist medications have become exceptionally popular for weight loss. High-profile celebrity endorsements and widespread media coverage has led to an overwhelming spike in demand. By any estimation, the American market for weight-loss GLP-1s is enormous. According to a Kaiser Family Foundation analysis, more than 40% […]
Payer Response to the Great Medicaid Unwinding
During the pandemic, the number of individuals in the U.S. enrolled in both fee-for-service and managed Medicaid programs increased dramatically. This increase was tied to a provision in the Families First Coronavirus Response Act, which boosted federal dollars to the states in exchange for keeping individuals covered through Medicaid, even if their eligibility changed since […]
Preparing for the Inflation Reduction Act’s Impact on Medicare Plans
Since its passage in 2022, many have speculated on the impact of the Inflation Reduction Act (IRA) on providers, manufacturers and payers—especially those with Medicare Advantage plans. Just over half of all Medicare beneficiaries are currently enrolled in a Medicare Advantage plan, and enrollment is projected to reach 60% of the eligible population by 2029. […]
Connecting the Dots: Part D Design, the IRA, and Biosimilar Uptake
Although the biosimilar market is expected to continue growing over the next few years, adoption thus far has been somewhat slow and uneven. Recent research published in Health Affairs takes a look at how upcoming provisions of the Inflation Reduction Act (IRA) are likely to impact biosimilar coverage, concluding that both Medicare beneficiaries and the […]
New Program Combats Drug Shortages by Strengthening Generics
According to the American Society of Health-System Pharmacists (ASHP), U.S. drug shortages are the highest they’ve been in more than two decades. As of the end of 2024’s first quarter, 323 drugs were in short supply, including many chemotherapy, ADHD, and pain and sedation medications. These drugs run the gamut from basic drugs to life-saving […]
Asembia Trends: The IRA, High-Cost Drugs and Personalized Care
At the beginning of May, almost 8,000 attendees descended on Las Vegas for Asembia’s AXS24 Summit. While all of the session speakers discussed the future of healthcare in one way or another, MMIT noticed a few common trends about the state of the industry today. If you missed the conference, read on for an overview […]