Research conducted by the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences provides evidence to support expansion of insurance plan coverage of noninvasive prenatal testing (NIPT), to women under the age of 35. It represents a first-of-its-kind published analysis of results from a risk-sharing agreement between biotechnology company Illumina, Inc. and insurer Harvard Pilgrim Health Care, conducting the research in partnership with advisory firm Real Endpoints to evaluate the impacts of the agreement.
read full article ›Real Endpoints (RE), an advisory and analytics firm entirely focused on enhancing appropriate access to healthcare innovation, announced today that its president, Susan Raiola, has been named to the PharmaVOICE 100 list of the most inspiring people in the life sciences industry. Susan was honored for her innovations in understanding what works among the plethora of patient and provider support programs and Hubs – and then crafting effective strategies specific to the client’s medicine.
read full article ›As effective as new gene therapy treatments may be, high setup costs, variable clinical responses, and issues with reimbursement and coding have resulted in significant losses for some manufacturers and providers. “The one-time administration for these therapies introduces a mismatch with benefits” said Jane F. Barlow, Real Endpoints Chief Clinical Officer. “The cost is front-loaded, but benefits accrue over time, creating a challenge as patients move in and out of plans. This is very different than what we see with chronic medications.”
read full article ›The industry has plenty of ways to define value. Thousands of academic and corporate health economists busily grind out cost-effectiveness analyses. CMS has designated five "compendia" as guides for reimbursable value, despite bizarrely opaque decision-making behind the compendias' choices.
read full article ›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.
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