Durable and potentially curative gene therapies and cellular treatments are being developed for a wide range of conditions. While a boon for patients, this could prove a financial bane for payers due to the fact that years of taking and reimbursing medications is condensed into a single, much larger, upfront payment at the time of an abbreviated treatment.
read full article ›Real Endpoints, which provides development and implementation of proprietary tools, has named Jeff Berkowitz as CEO and member of the board of directors. Most recently, Mr. Berkowitz served as an executive VP at UnitedHealth Group, CEO of it Optum International business, and as a strategic leader of OptumRx, its PBM, Mr. Berkowitz is a PharmaVOICE Red Jacket - 2014.
read full article ›Real Endpoints (RE), a leader in the development and implementation of proprietary tools to strengthen pharmaceutical market access for an evolving healthcare landscape, announced today that Jeff Berkowitz, a 20-year veteran of the pharmaceutical, drug distribution, pharmacy and payer industries, has joined the company as CEO and member of the board of directors. Jeff is one of the rare executives whose.....
read full article ›The first gene therapy to treat an inherited disease is out of the gate, but with a very high price tag. Many more gene therapies are on their way. How can they be priced to hit the sweet spot of affordability, access, and innovation?
read full article ›FDA guidance released on June 12 broadens a safe harbor that allows medical product manufacturers to communicate with payers, PBMs, formulary committees and similar entities. A primary goal is to make it easier to base payments on outcomes not mentioned on product labels, but there could be broader effects in the loosened restrictions oncommunications between medical product developers and payers.
read full article ›A law that comes into effect next year will squeeze profits from moderately priced drugs that treat common, chronic conditions and increase economic incentives to develop high priced medicines for rare or acute life-threatening diseases. Manufacturers of drugs to treat common, chronic conditions will be especially hard hit.
read full article ›Express Scripts was the last large independent pharmacy benefits manager, or PBM, in the US. A PBM acts as a middleman in negotiations between drugmakers and the payers (i.e. employers, insurers, and government), which buy medicines in the US. With its $67 billion takeover of Express Scripts, health insurer Cigna is sending a signal that it will have to get bigger to deal with the most pressing malady of US healthcare: soaring costs. By buying Express Scripts, Cigna hopes to gain more scale so it can drive a harder bargain when buying drugs and services, not just from pharmaceutical companies, but also the doctors and hospitals that provide patient care.
read full article ›A first-of-its kind value deal between Illumina Inc. and Harvard Pilgrim Health Care Inc. is intended to generate data to support broad reimbursement by multiple payers for non-invasive prenatal tests made by multiple testing companies.
read full article ›Biopharma is not moving as quickly in 2018 as its counterparts in adjacent industry segments, and is confronting a strategic dilemma on how to address the prospect of a much more powerful set of rivals in the ongoing battle to own the patient experience in medicine.
read full article ›Labeling for reduction of cardiovascular risk may help a bit with payers, but the "twin problem" of pricing and lack of patient adherence is likely to continue to present hurdles for reimbursement.
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