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Radar On Market Access: Managed Care Strategies for Specialty Pharmaceuticals

Posted by Matt Breese on May 22, 2018

A survey by EMD Serono, Inc. revealed that managing oncology drugs and services remains the top challenge for health plans, tied with determining the value of specialty drugs and ensuring clinically appropriate use of specialty therapies.
 
Released at the end of April, the 14th edition of the EMD Serono Specialty Digest: Managed Care Strategies for Specialty Pharmaceuticals is based on survey responses from 59 commercial health plans representing more than 76 million covered lives. 
 
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Topics: Industry Trends, Market Access, Data & Analytics

Radar On Market Access: Pharma's Role in Prior-Authorization Conflict

Posted by Matt Breese on May 8, 2018

Through funding of patient support programs and related hub services, pharma companies are playing a role in lessening the prior-authorization conflict between insurers and providers, AIS Health reported. .
 
Prior authorization (PA) is the exchange of patient health and medication information between a provider and a plan to make a coverage determination. Yet the most recent survey by the American Medical Association (AMA) showed that 92% of respondents agree that PAs delay therapy access, while 84% considering it a “high” burden. 
 
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Topics: Industry Trends, Data & Analytics

Radar On Market Access: CVS’s Chronic Kidney Disease Program

Posted by Matt Breese on May 3, 2018

CVS Health Corp. recently unveiled an initiative aimed at improving the management of chronic kidney disease (CKD), a costly condition that affects millions in the United States, AIS Health reported.
 
The multipronged program incorporates, among other things, a focus on early disease identification and patient education. According to estimates from the Centers for Disease Control and Prevention, 30 million people in the U.S. have CKD. But many of them don’t realize it. 
 
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Topics: Industry Trends, Data & Analytics, Payer

Radar On Market Access: Statin Gender Bias

Posted by Matt Breese on May 1, 2018

Women remain less likely than men to receive guideline-recommended, high-intensity statin therapy within 30 days after hospitalization for myocardial infarction (MI), AIS Health reported based on recent research published in the April 24 Journal of the American College of Cardiology.
 
The research looked at nearly 17,000 adults in the U.S. younger than 65 with commercial insurance and about 71,000 seniors ages 66-plus with Medicare coverage who were hospitalized for MI between 2014 and 2015. They found that 47% of women vs. 56% of men filled a high-intensity statin prescription within the 30-day post-hospitalization period. 
 
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Topics: Industry Trends, Market Access, Data & Analytics, Payer

Radar on Market Access: Specialty Drug Spend

Posted by Matt Breese on Apr 26, 2018

The United States saw a 0.6% increase in net spending on medications to $324 billion last year, AIS Health reported based on IQVIA Institute for Human Data Science’s report.

Those numbers represent "the amount being received by pharmaceutical manufacturers net of rebates, off-invoice discounts and other concessions," said Murray Aitken, executive director of the institute. But on an invoice basis, total spending was $453 billion, according to Medicine Use and Spending in the U.S.: A Review of 2017 and Outlook to 2022.

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Topics: Specialty, Industry Trends, Data & Analytics

Radar On Market Access: Managing Specialty Drug Costs as Top Employer Concern

Posted by Matt Breese on Apr 12, 2018

As costs for specialty drugs continue to rise, managing those costs remains employers’ top concern, according to a recent Pharmacy Benefit Management Institute (PBMI) study.
 
Since 2011, medical benefit spending has risen 55%, and “double-digit average specialty trend under the pharmacy benefit has been the norm since 2007,” notes PBMI’s 2018 Trends in Specialty Drug Benefits
 
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Topics: Industry Trends, Data & Analytics, Payer

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 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

Perspectives on Triggered Messages

Posted by Matt Breese on Feb 6, 2018

Data is nothing new to pharmaceutical marketers, who have become accustomed to using data to generate triggered messages, a near-real-time reaction to certain events or decisions, to their providers.
 
The next step is to go beyond simple messaging and personally tailor the message across varied platforms by using analytics and predictive tools, says Jose Ferreira, vice president of customer experience and data management at CMI/Compas. 
 
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Topics: Data & Analytics, Branding & Marketing

Trends That Matter for HGH Treatments

Posted by Matt Breese on Jan 11, 2018

In our weekly Trends that Matter series, we provide infographics, articles and recent news from healthcare influencers to highlight general trends affecting the pharmaceutical industry. This week's featured topic is human growth hormone (HGH) treatments. 

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

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Topics: Market Access, Data & Analytics