AstraZeneca and other biopharmas wait with bated breath for the first drug price tags to emerge from Germany’s new early added-benefit assessment process. So who’s winning as this hastily-introduced system undergoes its final tweaks? For now, we think it’s 1-1, payers and pharma. But that score could soon change. Industry has lost out on reference pricing: if negotiations between sponsors and the sick funds association hit the wall (as several are expected to do, especially … Continue reading
Cancer Pathways: A Bitter Pill For Biopharma
One big message from the first experiments with cancer pathways: they’re making it easier to predict therapy winners and losers. That emerged loud and clear from Real Endpoints’s March 20th webinar exploring cancer pathways. (If you missed the live event, you can access a free archived version by clicking on this link.) In the new pathways world “we’d have no choice but to cover” a new drug that’s very expensive but improves overall survival, noted Lee Newcomer, UnitedHealthcare’s senior vice president of … Continue reading
The Healthcare Round-Up: 3/21 -3/28
All eyes are on Capitol Hill this week as the Supremes hear oral arguments in one of the most important –and politicized—cases in decades: the constitutionality of the Affordable Care Act, the signature piece of legislation passed thus far in Barack Obama’s presidency. It’s anybody’s guess how the Court will vote –questions on day 2 tied to the constitutionality of the individual mandate were pointed and seemed to fluster the administration’s lawyer Donald Verrilli. One … Continue reading
Is France Creating Its Own NICE?
Sort of. It seems that the French are getting more comfortable with the idea of calling health-economics by its real name, and of carrying out explicit cost-effectiveness evaluations a la NICE in the UK. Equally worrying for pharma is that France — with its top-ranking pharma-per-capita spend — is also looking to its other neighbour, Germany, for ideas on how to further tighten entry hurdles for new pharmaceuticals. The new HTA acronym to note: CEESP, the Commission d’Evaluation … Continue reading
The Healthcare Round-Up: 3/14 – 3/21
Put a spring in your step and read Real Endpoints’s weekly round-up of reimbursement related news. Overseeing Cancer Drug Regimens: Here’s a scary find. On March 16 researchers from Medco Research Institute reported new data at the American Society for Clinical Pharmacology and Therapeutics annual meeting showing that a high percentage of patients on oral kinase inhibitors like Gleevec or Tarceva are also taking medicines that reduce the effectiveness of the cancer treatment. In total, … Continue reading
Providers Have A Treasure Trove of Health Outcomes Data: When Will Pharma Dig In?
If you’ve been reading our past blog entries (see here, here, and here), you know pharmas are scrambling to woo insurers and pharmacy benefits managers to get access to real world evidence that supports the value –and hence utilization—of their drugs. But as the race to lock-up access to valuable outcomes-based data continues, there are other data troves that, thus far, remain untapped–at least by industry players. These include the data warehoused in so-called integrated … Continue reading
The Healthcare Round-Up: 3/7 – 3/13
The Legality of Co-pay cards: It’s no secret co-pay cards are a contentious issue; now, they’ve been taken to the courts. Last week, the consumer advocacy group, Community Catalyst, filed suit against 8 drug companies seeking to ban the use of co-pay cards on behalf of unions that provide drug benefits for civilian and uniformed municipal workers in New York City, carpenters in New England, and plumbers in various states. Among the drug companies specifically … Continue reading
The Healthcare Round-Up: 2/28 – 3/6
Blue Shield of CA Seeks Damages from Physician Group: Last week Blue Shield of California filed for $10.5 million in damages from Monarch HealthCare, since last fall a division of UnitedHealthcare’s Optum. The tension between Blue Shield and Monarch is likely to be a sign of things to come as the healthcare market continues to restructure and the line between payers and providers blur. Blue Shield alleges that Monarch, a 2300-physician association serving nearly 200,000 patients, … Continue reading
Why Value-Based Pricing May Be Dead
Perhaps it was too good to be true. A value-based approach to pricing branded medicines that would increase access and improve outcomes, but also control costs….and stimulate innovation by keeping companies happy. Such was the proposal released by the UK Department of Health in late 2010. Briefly, the idea was to introduce a range of maximum price thresholds reflecting the different values medicines offer. These thresholds would be determined by various factors, including an evaluation … Continue reading