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Radar On Market Access: Changes to Medicare Part D Coverage Gap

Posted by Matt Breese on Mar 22, 2018

The Bipartisan Budget Act of 2018, passed Feb. 9, could make some pharmaceutical companies take a multibillion dollar hit, industry experts told AIS Health.
 
The legislation closes the Part D coverage gap discount program in 2019 as opposed to 2020. It reduces beneficiaries’ coinsurance while they are in the so-called donut hole from 30% to 25% next year and increases brand-name manufacturers’ discounts provided to patients from 50% to 70%. 
 
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Topics: Industry Trends, Provider, Payer

Radar On Market Access: Rebates for Specialty Drugs

Posted by Matt Breese on Mar 20, 2018

UnitedHealthcare’s plan to apply point-of-sale rebates for more than 7 million members might be a game changer, industry experts told AIS Health.
 
Amid a lot of finger pointing among stakeholders over who benefits from rebates, United unveiled the approach to provide insured group patients with estimated point-of-sale discounts, beginning Jan. 1, 2019. Members can log in to myuhc.com or use the UHC mobile app to find out the discounted price. 
 
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Topics: Industry Trends, Payer

MMIT Reality Check on Narcotic Pain (Mar 2018)

Posted by Matt Breese on Mar 20, 2018

According to our recent payer coverage analysis for narcotic pain treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

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Topics: Specialty, Market Access, Branding & Marketing

MMIT Reality Check on Immunology: Rheumatoid Arthritis (Mar 2018)

Posted by Matt Breese on Mar 18, 2018

According to our recent payer coverage analysis for rheumatoid arthritis treatments, combined with news from key healthcare influencers, market access is shifting in this immunology drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

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Topics: Specialty, Market Access, Branding & Marketing

Trends That Matter for Drug Expenditures

Posted by Matt Breese on Mar 15, 2018

Prime Therapeutics reported overall drug expenditures decrease across all three of its business lines in 2017. 

Specifically, the PBM said it lowered drug trend to -0.2% for commercial, -0.8% for Medicare Part D and -5.4% for Medicaid in 2017. The drug trend in 2016 was 2.5% for commercial, -0.7% for Medicare and 6.9% for Medicaid.

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Topics: Industry Trends, Data & Analytics

Perspectives on Cigna-Express Scripts Deal

Posted by Matt Breese on Mar 13, 2018

Cigna Corp. on March 8 said it would buy Express Scripts Holding Co. in a $67 billion deal, a move that analysts say furthers the trend of payers and PBMs joining together in a single diversified entity. 

Cigna agreed to pay $48.75 in cash and 0.2434 shares of stock of the combined company for each Express Scripts share. Such a move would give the insurer control over the pharmacy space and a greater scale that helps cut costs, according to Jefferies analyst David Windley. 

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Topics: Industry Trends, Branding & Marketing

Trends That Matter for Pharma and Biotech Industry

Posted by Matt Breese on Mar 8, 2018

Today’s pharmaceutical industry requires stakeholders to continually assess the current status and anticipate future changes. PharmExec.com highlights the following trends to watch in 2018 in the pharma and biotech space.

  • Though efforts to repeal the Affordable Care Act failed in 2017, the removal of the individual mandate requirement might reduce by millions the number of Americans with health care coverage and drive up premiums.
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Topics: Industry Trends

Perspectives on Analytics Revolution in the Life Sciences Industry

Posted by Matt Breese on Mar 6, 2018

Looking ahead, life sciences companies should focus on making full use of analytics to translate insights to action, given that the industry is undergoing a transformative shift. 

Over the past few years, life sciences companies have been able to make more sophisticated and precise advances. Yet instead of changing decisions, their insights remain diagnostic. In 2018, leading brands should keep investing in infrastructure and rapid experimentation to generate prescriptive analytics. 

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Topics: Industry Trends, Data & Analytics, Branding & Marketing

Trends That Matter for Immune Globulin

Posted by Matt Breese on Mar 1, 2018

In our weekly Trends That Matter series, we provide infographics, articles and recent news from health care influencers to highlight general trends affecting the pharmaceutical industry. This week's featured topic is Immune Globulin. 

According to our recent payer coverage analysis for immune globulin, combined with news from key health care influencers, market access is shifting in this drug landscape. Pharmacy benefit coverage shows a tremendous increase in restrictive Medicare formularies and a similar shift for health exchange formularies, while standard commercial plans are relaxing coverage.

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Topics: Specialty, Industry Trends

Perspectives on 2018 Pipeline

Posted by Matt Breese on Feb 27, 2018

The rise of CAR-T and other gene therapies, newly identified oncology targets and next-generation sequencing will shape the pipeline for 2018.
 
With the first CAR T-cell therapy approved, this new form of immunotherapy has a bright future. Yet drug companies also need to respond to worrisome side effects, such as severe cytokine release syndrome.
 
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Topics: Specialty, Industry Trends, Product Release