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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

MMIT Reality Check on Psoriasis (Q2 2018)

Posted by Matt Breese on May 18, 2018

According to our recent payer coverage analysis for psoriasis 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

Radar On Market Access: Outcomes-Based Drug Pricing

Posted by Matt Breese on May 15, 2018

While outcomes-based contracts for prescription drugs are a continual hot topic in the health care industry, experts who spoke on a panel May 1 at the World Health Care Congress cited several barriers that are keeping these contracts from proliferating widely: chiefly, not enough reliable data and regulatory issues such as the federal antikickback statute.
 
"The beautiful thing about value-based contracts is we are basically putting the patient at the center of everything," said Enrique A. Conterno, senior vice president of Eli Lilly and Co.
 
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Topics: Industry Trends, Market Access, Payer

MMIT Reality Check on Hypertension (Q2 2018)

Posted by Matt Breese on May 11, 2018

According to our recent payer coverage analysis for hypertension 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

Radar On Market Access: CMS Targets Opioid Utilization

Posted by Matt Breese on May 10, 2018

CMS on April 2 finalized new policies in its 2019 Rate Announcement and Final Call Letter for Medicare Advantage (MA) and Part D plans that continue to focus heavily on ways to monitor and decrease opioid misuse, AIS Health reported.
 
To reduce the potential for chronic opioid use or misuse, CMS said that it expects Part D plan sponsors to implement a hard safety edit to limit initial opioid prescription fills for treating acute pain to no more than a seven-day supply. It also requires plan sponsors to implement an opioid care coordination edit at 90 morphine milligram equivalents per day.
 
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Topics: Industry Trends, Market Access, Payer

MMIT Reality Check on Respiratory (Asthma/COPD) (May 2018)

Posted by Matt Breese on May 2, 2018

According to our recent payer coverage analysis for asthma and COPD 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

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: Psoriasis Therapies

Posted by Matt Breese on Apr 24, 2018

With various psoriasis therapies available, payers should make certain they have a complete picture of the autoimmune condition and the various factors that could impact their members’ treatment, AIS Health reported.
 
According to the American Academy of Dermatology, psoriasis affects about 7.5 million people in the United States, with about 150,000 new cases each year. As the condition can impact relationships, it could lead to depression and stress. Other common conditions may occur in patients with psoriasis as well, including psoriatic arthritis, uveitis, metabolic syndrome and diabetes.
 
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Topics: Industry Trends, Market Access, Payer

MMIT Reality Check on Viscosupplements (Apr 2018)

Posted by Matt Breese on Apr 20, 2018

According to our recent payer coverage analysis for viscosupplements, 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

Radar On Market Access: Opioid Crisis

Posted by Matt Breese on Apr 19, 2018

While the fiscal year 2018 omnibus bill committed almost $4 billion to fighting the opioid epidemic, industry experts are debating who should be shouldering the blame for the crisis, AIS Health reported.
 
Meghan Oates-Zalesky, vice president of marketing at InCrowd, says, "though there was a concerted effort by a single drugmaker in the nineties to change prevailing attitudes towards opioids at the time, most manufacturers do not subscribe [to] such practices…[Yet,] it is never in the best interest for a manufacturer to ignore the harmful side effects of its drug."
 
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Topics: Market Access, Provider, Payer