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Matt Breese

Manager, Marketing at MMIT
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Recent Posts

Radar On Market Access: Step Therapy for Part B Drugs

Posted by Matt Breese on Aug 14, 2018

In a move that industry analysts see as a positive development for the managed care sector, CMS issued new guidance that will allow Medicare Advantage (MA) plans to use step therapy for Part B drugs starting in 2019, AIS Health reported.
 
CMS is giving MA plans that offer a Part D benefit the ability to "cross-manage" drugs across Part B and Part D. In other words, plans could require patients to try alternatives covered within Part D before moving on to relatively expensive physician-administered drugs in Part B, Credit Suisse analyst A.J. Rice explained in a research note.
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Topics: Specialty, Industry Trends, Market Access

MMIT Reality Check on Tardive Dyskinesia (Aug 2018)

Posted by Matt Breese on Aug 10, 2018

According to our recent payer coverage analysis for tardive dyskinesia 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, Payer, Branding & Marketing

Perspectives on REMS Programs

Posted by Matt Breese on Aug 9, 2018

The FDA’s Risk Evaluation and Mitigation Strategy initiative — under which the agency requires pharmacy manufacturers to develop a REMS program for certain therapies in order to manage risks while still allowing people to have access to it — may present challenges to many stakeholders. But manufacturers in particular may use REMS to their advantage, AIS Health reported.
 
According to Glenn Carroll, principal at Deloitte, one of the top challenges that manufacturers may grapple with is the "increasing complexity of developing and administering" REMS. He says, "many of the REMS being developed today are more rigorous to implement than what we’ve seen in the past."
 
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Topics: Specialty, Industry Trends, Provider, Payer

Radar On Market Access: New Class of Migraine Drug Drives Changes

Posted by Matt Breese on Aug 9, 2018

For years, clinicians have mostly prescribed generic prescription drugs to treat migraines. But a new class of relatively high-cost specialty biologic products is threatening to upend payers' calm, AIS Health reported.
 
Current migraines treatments supported by clinical evidence "include beta blockers, tri-cyclic anti-depressants and some seizure medications," according to Mesfin Tegenu, R.Ph., president of PerformRx, LLC. The situation changed in mid-May, when Amgen, Inc and Novartis AG's Aimovig got the regulatory greenlight in the U.S., and two more calcitonin gene-related peptide (CGRP) inhibitors — Teva Pharmaceuticals' fremanezumab and Eli Lilly and Co.'s galcanezumab — are under FDA review, says an Institute for Clinical and Economic Review (ICER) report on migraine treatments.
 
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Topics: Specialty, Industry Trends, Market Access, Payer

Radar On Market Access: Drug-Diagnostic Co-Development

Posted by Matt Breese on Aug 7, 2018

As knowledge around biomarkers grows, more drugs are coming onto the market with FDA-approved labels indicating their use with a particular diagnostic test. With most manufacturers nowadays choosing not to develop their own companion diagnostic but rather to partner with an outside firm, pharma companies need to be able to incorporate a diagnostic strategy into their drug development approach, AIS Health reported.
 
Previously some companies would develop both the drug and the diagnostic, but the number that now do so has declined. According to Amit Agarwal at Deloitte Consulting LLP, "diagnostic is a very different margin and business model than the pharmaceutical industry….The economics of it differ pretty dramatically."
 
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Topics: Specialty, Industry Trends, Product Release, Provider

MMIT Reality Check on Crohn's Disease (Aug 2018)

Posted by Matt Breese on Aug 3, 2018

According to our recent payer coverage analysis for Crohn's disease 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, Payer, Branding & Marketing

Trends That Matter for Generic Drugs

Posted by Matt Breese on Aug 2, 2018

The Trump administration has touted competition as one way to bring down drug prices. With this goal in mind, the FDA recently released a pair of draft guidance documents aimed at helping generics get onto the market sooner while still upholding the focus on safety, AIS Health reported. 

One of the documents, titled Development of a Shared System Risk Evaluation and Mitigation Strategy (REMS) (83 Fed. Reg. 25468, June 1, 2018), offers recommendations for developing a shared system REMS for multiple drug products. 

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Topics: Specialty, Industry Trends, Payer

Radar On Market Access: Generic Firm as "Societal Asset"

Posted by Matt Breese on Aug 2, 2018

Earlier this year, Intermountain Healthcare teamed up with other health systems to start building a not-for-profit generic drug manufacturing business, with a goal to create "what we think…[is] a first-of-its-kind societal asset," said Dan Liljenquist, vice president of Intermountain Healthcare's Enterprise Initiative Office.
 
"Essentially, we're going to set this up where the governing members of this organization are going to act more like public service commissioners and build a public-utility-type model for the manufacturing and distribution of essential generic medications," he said.
 
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Topics: Specialty, Industry Trends, Data & Analytics, Payer

Radar On Market Access: FDA Aims to Give Biosimilars a Boost

Posted by Matt Breese on Jul 31, 2018

Continuing the Trump administration's spate of actions aimed at lowering prescription drug costs, the FDA recently unveiled the 11-step "Biosimilar Action Plan" designed to help get more biosimilar drugs to the market that can compete with pricey biologics, AIS Health reported. 
 
While the FDA has approved 11 biosimilars, only three are currently being marketed in the U.S., FDA Commissioner Scott Gottlieb said. "Competition is, for the most part, anemic," he concluded, adding that an FDA analysis showed Americans could have saved $4.5 billion in 2017 if all the approved biosimilars were available to consumers.
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Topics: Specialty, Market Access, Product Release

MMIT Reality Check on IVIG (Jul 2018)

Posted by Matt Breese on Jul 27, 2018

According to our recent payer coverage analysis for immune globulin 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