Featured Insights

Insights

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November 14, 2019

In Vivo

Market Access 2020: Understanding US Payer Expectations

Consolidation on the payer side is changing the dynamics of success in health care.  Principals at Real Endpoints LLC examine

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June 11, 2019

Elsevier

Are Payers Ready, Willing, and Able to Provide Access to New Durable Gene Therapies?

Access to new gene therapies may be impacted by payer ability to absorb the cost of coverage. Payers are open to innovative financing models that improve financial predictability and reward clinical performance.

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March 1, 2019

In Vivo

Paying for Pharmaceutical Value: The Problem of a One-Size-Fits-All Definition

Combining a set of tailored, regularly updated value assessments with risk-sharing contracts allows us to deal with evidentiary uncertainty by

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February 13, 2019

AJMC

Examining New Payment Ideas for Curative Therapies

How can the health industry ensure that cutting-edge gene therapies and other curative treatments get to the patients that need them, without leaving payers financially exposed? Jane F. Barlow, MD, MPH, MBA, was a speaker at the FoCUS (Financing and Reimbursement of Cure in US) Project at MIT, during the session "Putting Theory into Practice" she was quoted saying the “accessibility issue lies largely with payers.” All payers are different, and “a lot has to do with how they manage risk in their population as well as the regulatory constraints."

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January 28, 2019

STAT

AstraZeneca strikes a ‘novel’ deal with Medicare plan to lower patient out-of-pocket costs

In a novel bid to lower medicine costs, a drug maker has agreed to adjust the discounts that a Medicare Part D plan will receive for a treatment based on how patients respond — and the deal automatically lowers out-of-pocket costs for patients, as well. “One of the major problems we have in getting drug therapy used by people who really need it is that, for those people who are on Medicare, who have to pay co-insurance or copays, there is no really good way for manufacturers to provide copay assistance, because they are not allowed to do so,” said Roger Longman.

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November 18, 2018

STAT

What rebates? Express Scripts touts a new plan to appease critics of the opaque drug-pricing system

Amid national angst over prescription drug pricing, Express Scripts is touting a new scheme it says will lessen the behind-the-scenes role that rebates play in rising costs. In effect, Express Scripts would create a two-tier system for its customers which could choose between a formulary with a high list price and high rebate, or the newer plan that will offer a lower list price and lower or no rebate.

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