UnitedHealth’s outcomes-focused research alliance with Mayo Clinic, announced Jan. 15, reminds us of big data’s central role in creating a value-driven US health care system. The tie-up claims to have created the biggest-yet trove of claims-plus-clinical patient records in the US, combining over 100 million claims records from United’s Optum’s health services division with over 5 million clinical records from Mayo. As such, it’s powerful. Collating top-level insurance claims with in-depth clinical reports is as good … Continue reading
Deal Away, But Don’t Forget What Payers Think
As pharma and biotech execs at JP Morgan in San Francisco craft the next round of life- and/or growth-extending deals, they’ll hopefully remember that the key issue is now reimbursability, not approvability. A survey released this week by BayBio, the California Research Institute and PwC (flagged up by Xconomy) provides a timely reminder. More than half of the 157 Californian-biotech CEOs questioned said that securing insurance coverage and reimbursement for their products became more difficult in … Continue reading
Reimbursement “Furies” Real, But Won’t Avenge Pharma Til 2017, Says Citi
“Beware the Three Furies,” warns Citi analyst Andrew Baum. In a report for pharma investors published Nov. 29., Baum turns to classical mythology to describe shared savings models, drug pathways and ACOs — the forces that will soon dominate US health care plans. He’s chosen an interesting analogy: The Three Furies were goddesses of vengeance, who punished the wicked for their crimes; they’re also described as “tormenting those who have yet to atone for their sins”. … Continue reading
Sanofi Blinks First: Zaltrap Price Cut Proves HTA Has Reached The US
Sanofi’s decision last week to cut the price of its colon cancer drug Zaltrap by up to 50% showed that the US market is no longer immune to European-style drug price pressure. Never mind that the move was partly a result of a messed-up calculation on Sanofi’s part: this was a defining moment in the evolution of America’s troubled health care system. That the price of a drug was cut at all, and voluntarily (albeit under pressure), is … Continue reading
Actelion’s Opsumit Will Test Whether Outcomes Data Can Replace Head-to-Head
Actelion pulled out all the stops in designing the Phase III trial of its pulmonary arterial hypertension drug Opsumit (macitentan), filed at FDA on Oct 22. And no wonder: the biotech’s future depends on it, as its own top-selling PAH treatment Tracleer faces patent expiry in 2015. But Opsumit’s regulatory and reimbursement path should also interest any other drug developer seeking to test what kinds of data payers require in order to prioritize a next-in-class … Continue reading
Shifting Docs’ Incentives May Push Pharma Towards Portfolio Deals
As cost-of-care-focused experiments start — at last — to shift doctors’ incentives away from prescribing the most expensive treatment, there’s opportunity for pharma to offer ‘portfolio’ deals, spanning a range of drugs, and support services, across an entire therapeutic area. At least, that’s the view of Harvard Pilgrim’s CMO Michael Sherman, who is among the handful of payers testing new care delivery models with physician groups. You can hear more from him in this short … Continue reading
The Big-Data Race Is On. But Real World Evidence Won’t Solve Pharma’s Trust Problem
As payers step up their hunt for drugs’ ‘value’ – defined, in their eyes, in terms of outcomes — so pharma is scrambling for real world data that can prove how well their products work in practice. Pharma faces two key challenges in doing this. The first is generating or accessing enough high-quality information to ensure statistical reliability. The second (tougher) challenge: persuading payers to trust it. We’ll be addressing both of these at our … Continue reading
The Healthcare Round-up: July 30-Aug 3
Competition’s the theme for this week’s round-up, brought to you from Olympic city, London. While the world’s best and fastest athletes battle it out for gold (checked periodically for performance-enhancing drugs by our friends at GSK), so the competition’s hotting up among health insurers and providers, too — at least if (some) politicians get their way. The goal: ultra-efficient, cost-effective medical care. In Europe’s engine-economy, Germany (current Olympic medal-count: 18) the government’s pushing for more … Continue reading
The Healthcare Round-up: July 20-27
Might Ultra-Orphans Enjoy An Easier Passage Past NICE? Perhaps. After much back-and-forth, it seems our old friend NICE will, starting in 2013, assess the cost-effectiveness of high-cost drugs for patients suffering from ultra-rare diseases (affecting fewer than 500 patients across England). These kinds of products, increasingly popular with drug firms, generally struggle to meet NICE’s general evidence requirements (given the difficulty of data collection). Thus, in the past, the agency has considered – and approved … Continue reading
The RE Healthcare Round-Up
Real Endpoints’ Weekly Healthcare Round-Up has returned. Cue Carol Anne of the ’86 cult flick Poltergeist II – or, if you prefer, the infamous, avenging nerd Lewis (Revenge of the Nerds II) or the exuberant but dorky Stu Price (The Hangover). Feel free to mock our retro-culture cool, but don’t doubt our enthusiasm…or the importance of synthesis. In the six weeks since our last Round-Up, we’ve seen the approval of Qsymia and Belviq, two new … Continue reading