News articles featuring quotes from Real Endpoints

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January 9, 2020

PharmExec.com

Payer Perspective on Reimbursement of One-Time High-Cost Durable Therapies

by Jane Barlow

The reimbursement of emerging durable and potentially curative cell and gene therapies challenge U.S. payers due to their high upfront costs. In addition, the lack of long-term clinical durability data amplifies uncertainties which complicate payer coverage and reimbursement determinations. These cell and gene therapy characteristics could negatively impact patient access and ultimately, future developer innovation.  The Financing and Reimbursement of Cures in the U.S. (FoCUS) project was launched in 2016 by MIT with the objective of elucidating the challenges and financial impact created by durable/potentially curative therapies and providing implementable models to manage the financial impact on the U.S. healthcare system.

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October 8, 2019

EurekAlert

Real Endpoints: Research supports expanding insurance coverage of non-invasive prenatal testing

by University of Colorado

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.

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August 6, 2019

RE’s president recognized for innovation in translating theoretical reimbursement coverage to real access for patients

by Real Endpoints

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.

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May 17, 2019

Pharmacy Technology Report

Gene Therapies Force Payment Innovation

by Gina Shaw

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.”

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April 12, 2019

In Vivo

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

by Roger Longman

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.

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January 27, 2019

PharmExec

Precision Financing of Durable, Potentially Curative Therapies

by Jane Barlow, MD, MPH, MBA

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.

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