The Next Big Budget Breaker on Payers’ Minds

Nearly 300 cell and gene therapies are currently in development. Though not all will make it through to approval, the gene/cell therapy revolution appears to be growing unabated. What big problems might this create for payers and our current healthcare system?

Payer and Health System Consolidation: An Upward Trend

As consolidation increases, so too does payer and organized provider buying power. More than ever, biopharmaceutical manufacturers must demonstrate the economic and clinical value of their products. Take a closer look at some of the recent consolidations and how they might impact drug access, coverage, and reimbursement.

Questions Unanswered in HHS Safe Harbor Proposal

With the release of the HHS safe harbor proposal, more information is available than when only the title was public. Indeed, over the past few weeks, many articles have been published with detailed summaries of the proposal—yet, many questions remain. For All Access, Todd Edgar breaks down some of the most granular issues to consider and asks the question: How prepared is the market for a change of this magnitude?

Medicare & ICER: Two Predictions for 2019

Drug costs are a main concern for both government and commercial payers. In 2018, CMS tackled drug costs in Medicare through several measures. Will the trend continue in 2019? Meanwhile, the use of ICER’s value framework to inform commercial payer decision makers is increasing. Are value- and outcomes-based strategies more important?

Offensive or Defensive Drug Cost Strategies: Which Will Give Payers and Health Systems the Best Chance to Lower Drug Costs?

When it comes to winning in the effort to reduce rising drug costs, there are new offensive and defensive strategies in play. What works better in pharma? Does a good offense beat a good defense?