Trends, Entrants, and Developments (TEDs) Impacting Market and Drug Therapy Access

Happy New Year! I am Elizabeth Oyekan, PharmD, FCSHP, CPHQ, Vice President – Access Experience Team, editor of the All Access Newsletter. I cannot believe we are in 2022—I still remember when 2021 started and how we thought we would see the stabilization of COVID-19, only to encounter new variants, leading us to realize that this will be more of an endemic than a pandemic. At the same time, health care experienced other changes in areas such as precision medicine, the increasing use of data and real-world evidence in the formulary decision-making process, policies impacting health care, and much more.

In this edition of the All Access Newsletter, we have asked our key expert ex-payers to provide insights into the trends and developments anticipated to affect health care and therapy access in 2022 and the potential impact on payers, patients, and/or pharma.

1. Potential Oncology Price Wars from Across the Ocean?: Jennifer Williams, PharmD, BCOP – VP– ACCESS EXPERIENCE TEAM

Jennifer will take us into the emerging competitive world of oncology therapies from across the ocean as China increasingly becomes a hot spot for drug development, with multiple therapies in their pipelines. In China’s attempt to gain market share in the oncology space in the United States, price reductions for therapies such as immuno-oncology (IO) drugs are being explored. If these pipeline therapies demonstrate clinical equivalency to current IO therapies in the United States, a potential oncology therapy price war leading to payer controls and price reductions may ensue.

2. The Evolution of Biomarkers and Germline Testing in Therapy Selection and Disease Management: Erin Lopata, PharmD, MPH – VP– ACCESS EXPERIENCE TEAM

Erin reviews the evolution of biomarkers and germline testing in therapy selection and disease management, including opportunities leveraging modeling, digital technology, and artificial intelligence, for the identification of targetable mutations in oncology and beyond.

3. The Impact of the Build Back Better Act Price Negotiations on Commercial and Medicare Drug Access: Ryan Cox RPh, MBA – VP– ACCESS EXPERIENCE TEAM

Over the last several years, a myriad of legislative bills have been proposed in an attempt to control and/or manage drug costs, but to no avail. Now, in President Biden’s new Build Back Better Act (BBBA), several provisions address drug spending by the federal government and private payers. Ryan will take us through these provisions as well as the implications and impact of the BBBA Price Negotiations on Commercial and Medicare Drug Access.

4. COVID-19 and the New Chronic Disease: Cynthia Miller, MD, MPH, FACP – VP– ACCESS EXPERIENCE TEAM

While we once hoped that the pandemic would be a time-limited phenomenon, we now know that it will affect us long into the future. Cynthia will educate us on the emergence of this new phenomenon and how health care stakeholders can help pivot and create new strategies to deal with COVID long-term, including creating new strategies for health care delivery.

5. Can Real-world Evidence from Database Research Shape Therapy Choices?: Dan Danielson, MS, RPh. – SENIOR DIRECTOR– ACCESS EXPERIENCE TEAM

Dan explains the increase in data analytics and real-world evidence in supporting therapy choices for patients, especially in the area of oncology, and some of the emerging tools that are being used.

We believe that you will find these health care and therapy TEDs and their impact on access insightful as you navigate the payer landscape. As always, please feel free to drop me a note and let me know if you have a topic suggestion for the payer team to address, and we will do our best to cover it in a future edition.

Best regards,

Elizabeth Oyekan
PharmD, FCSHP, CPHQ
Vice President,
Access Experience Team
EMAIL ELIZABETH