STAT

MARCH 9, 2023

But a question from a biotech CEO started me thinking about not only how to pay for them, but how to offer guarantees for these therapies to payers who rightfully wanted reassurances that they were paying for something that works for their beneficiaries. As an investment banker, I was sure they would someday change how patients were treated.

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Drug Channels

SEPTEMBER 15, 2023

Nicole summarizes MMIT’s research on payers’ views of two crucial market changes: (1) the Inflation Reduction Act of 2022’s requirement to cap insulin prices at $35 for Medicare beneficiaries, and (2) manufacturers’ reduction in list prices for certain insulin products. Today’s guest post comes from Nicole Mayer, Senior Analyst at MMIT.

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Pharmaceutical Technology

SEPTEMBER 5, 2022

Factors such as increasing access to health information, the introduction of new medical treatments and technologies and the spike in birth rate are increasing the need for payers in the pharmaceutical industry. Payers ensure the delivery of the best possible health outcomes to the patients from their financial plan.

Documentation 59

Documentation Hospitals 59

pharmaphorum

OCTOBER 26, 2020

While the benefits of preventive measures are established, integration of many options can be limited when payers do not agree on what are considered adequate or optimal levels of preventive care. This is especially true when preventive care involves a direct cost to payers. Understanding payer views of preventive care.

Vaccines 130

Vaccines 130

PharmaVoice

FEBRUARY 28, 2023

With more gene therapies headed to market, novel payment methods are emerging from regulators and academia.

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pharmaphorum

MAY 19, 2021

However, value can mean different things to different payers. In this article, Cecilie Alstad, senior analyst at Research Partnership, discusses how an approach established in the world of marketing and commercial strategy could be the key to significantly improving pharma’s payer engagement.

Communication 72

Communication 72

PharmExec

JULY 27, 2022

Using data visualizations to improve access to payers.

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pharmaphorum

NOVEMBER 11, 2022

The decisions will directly impact the value story for payers who, as the landscape becomes more complex, are looking for more nuanced and detailed information on the product value. However, for payers, as well as regulators, healthcare professionals, and patients, a new mode of action is not a value driver.

Packaging 52

Packaging 52

Drug Channels

MARCH 12, 2021

Carolyn and Ritupriya discuss the challenges that manufacturers face in getting payer coverage for new drugs. They argue that a manufacturer can use analogs to improve messaging to payers, identify coverage challenges, and accurately predict payer uptake. Read on for Carolyn’s and Ritupriya’s insights.

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STAT

FEBRUARY 15, 2024

My four-doctor gastroenterology practice came under severe stress in 2007 due to catastrophic fee schedule cuts from our two largest payers. As an independent physician, I know exactly why so many are making that choice. Luckily, I was able to join forces with other local independent docs to form a bigger group practice.

Hospitals 361

Hospitals 361

PharmExec

OCTOBER 12, 2023

Payers won’t let these products break the bank.

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STAT

MAY 1, 2024

 Adding to this budgetary stranglehold are payment delays and insurance claim denials by payers, which compromise patients’ access to health care and providers’ financial viability.

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241

Drug Channels

JULY 6, 2022

The boom in copay accumulators and maximizers has radically shifted payers’ views on manufacturers’ copay support programs for specialty drugs. Below, I review a new survey of commercial plan sponsors and contrast the findings to a comparable survey from 2018.

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PharmaVoice

DECEMBER 4, 2023

But hitting the heights will require overcoming payer and other issues. Market expectations for obesity drugs are soaring and competition is heating up.

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Pharmacy Times

FEBRUARY 29, 2024

Pharmacy's position at the intersection of the care team gives it a unique ability to connect providers, payers, and pharmaceutical manufacturers, and support patients to maximize their health outcomes.

Pharmaceutical Manufacturing 32

Pharmaceutical Manufacturing 32

PharmExec

JULY 22, 2022

New MMIT research highlights payers’ continued hesitancy toward PDTs. Here’s what manufacturers need to know.

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pharmaphorum

NOVEMBER 26, 2021

Payers are becoming savvier in accepting real-world data. Certara’s Lee Stern and Shawn Bates discuss the challenges and how pharma can use real-world data to meet payers’ needs. The post Leveraging real-world data to meet payers’ needs appeared first on. For years, clinical trial data was king.

Pharmaceutical Companies 52

Pharmaceutical Companies Pharmaceutical Companies 52

STAT

MAY 2, 2024

In a safety net hospital like ours, providers must account for 60 different quality metrics during each patient visit, many of which are “standalone,” or required by just one payer. Read the rest…

Diabetes 203

Diabetes Hospitals Vaccines 203

STAT

APRIL 17, 2024

Silicon Valley venture funds Andreessen Horowitz and Yosemite, the cancer-focused fund launched by Steve Jobs’ son Reed Jobs , are backing the small but growing group of companies eager to sift through complex pricing data to help patients and employers and payers looking to strike better deals.

Hospitals 282

Hospitals 282

STAT

JANUARY 27, 2023

After months of anticipation, the first biosimilar version of Humira will become available next week — a pivotal moment in the long-running debate about whether cheaper copies of pricey biologics can lower soaring U.S. health care costs.

Biosimilars 211

Biosimilars Drug Pricing 211

STAT

MAY 6, 2024

payers — commercial insurers, employers, and government—have often paid for medicines that other countries said were not cost-effective. Read the rest…

Drug Pricing 242

Drug Pricing 242

Pharmaceutical Commerce

OCTOBER 12, 2023

Payers won’t let these products break the bank.

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52

PioneerRx

MARCH 1, 2023

As pharmacists explore ways to get reimbursed for their services through a value-based care model, PioneerRx is right by your side with the ability to provide…

Documentation 52

Documentation 52

STAT

FEBRUARY 23, 2024

The drug, called Enbrel, cost insurers an average of $46,772 per patient per year, according to 2022 data from the state’s all-payer claims database. The state board evaluated two other drugs so far, but Enbrel was the first the board deemed unaffordable for Colorado patients.

Drug Pricing 277

Drug Pricing 277

STAT

JANUARY 16, 2024

But some doctors see that kind of cash and consolidation as the only way for their practices to survive — and now, they’re taking that message to Washington.

Hospitals 310

Hospitals 310

pharmaphorum

APRIL 28, 2024

Report from Evaluate shows growth in the orphan drugs sector is slowing down, in part as pharma and payers’ attention has refocused on treatments for more widespread conditions like obesity

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110

pharmaphorum

APRIL 28, 2024

Pfizer has said it will launch its just-approved haemophilia B gene therapy Beqvez with a warranty programme that will provide “greater certainty” to payers, after setting a price directly in line with a rival treatment.

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111

STAT

MARCH 22, 2024

Medicare previously wasn’t reimbursing for Wegovy, since the federal payer is legally barred from covering weight loss drugs.

Drug Pricing 298

Drug Pricing 298

Pharmacy Times

JULY 16, 2022

With the rapid pace of change in biosimilar payer benefit design, efforts to stay regularly updated on policy changes ahead of time become critical for patient care.

Biosimilars 49

Biosimilars 49

pharmaphorum

FEBRUARY 18, 2022

This includes patients, healthcare providers, and payers. The post The prevailing desire uniting patients, HCPs, and payers: a connected customer experience appeared first on. Perhaps counter-intuitively, during the pandemic, more choices and options opened up to patients and providers in the United States. READ THE FULL ARTICLE HERE.

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STAT

OCTOBER 23, 2023

As customers — often health systems, payers, or employers — and backers plot how they’ll invest shrinking budgets, they’re increasingly savvy about metrics, investors told STAT. They’re also less interested in rapid growth, and more keen on startups that can demonstrate savings and efficiency.

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STAT

JANUARY 4, 2024

Meanwhile, companies selling digital health services like telemedicine, health plans for virtual care, and AI tools for payers face a crucial year as they scramble to make good on profitability projections.

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STAT

AUGUST 21, 2023

Thanks to the surging popularity of obesity drugs, telehealth companies are pivoting from consumer-focused marketing and instead pitching payers and employers trying to figure out how to sustainable cover an expensive class of medicines, STAT tells us. Continue to STAT+ to read the full story…

Drug Pricing 219

Drug Pricing 219

STAT

JANUARY 13, 2023

Two reasons: It is expensive, and the long-term value of addiction treatment is often disregarded by insurance companies and other payers. Access to treatment for addiction has long plagued U.S. health systems.

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STAT

JUNE 23, 2023

Correspondingly, Medicaid is one of the primary payers of opioid addiction treatment in the U.S., Medicaid patients are already at disproportionate risk of opioid overdoses, almost four times higher than patients on commercial insurance. covering nearly 40% of adults under 65 with this chronic disease. Read the rest…

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Drug Channels

AUGUST 3, 2021

Healthcare Ecosystem: Payers, Providers, Producers , by Rob Burns. Looking for a summer beach read? I suggest The U.S. My friend Rob of the University of Pennsylvania’s Wharton School offers an exhaustive look into the commercial side of our complicated and confusing healthcare system. .

Hospitals 52

Hospitals 52

Drug Channels

NOVEMBER 9, 2021

Consequently, many commercial payers will adopt the more expensive product instead of the identical—but cheaper—version. Express Scripts will block both the branded reference product and the lower-priced, unbranded—but also interchangeable—version. As usual, patients will be the ultimate victims of our current drug pricing system.

Biosimilars 95

Biosimilars Drug Pricing 95