September 28, 2017


I’m Ami Gopalan, Vice President, Director, Payer Access Solutions, and I’d like to welcome you back to All Access, Precision for Value’s bimonthly newsletter sharing the latest payer insights, brought to you by our team of ex-payers. In this edition, Jeremy Schafer breaks down what the just-released 2019 Express Scripts Formulary Exclusion list means for payers, Andrew Cournoyer takes a closer look at the potential impact of the Trump Administration’s “American Patients First” initiative, Janet Serluco addresses how to stay on top of changing oncology coverage policies, and we share revealing survey results from payers about their readiness for the coming gene therapy revolution.

As always, we hope you find the insights in All Access to be thought provoking and helpful in navigating the payer landscape; however, we also want to know what’s on your mind. 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’ll do our best to cover it in a future edition.


Ami Gopalan

Ami Gopalan, PharmD, MBA
Vice President, Director,
Payer Access Solutions

All Access is a bimonthly newsletter that features key insights from our team of former payers, intended specifically for market access leaders. It is published by Precision for Value.

Guest Editor
Ami Gopalan

Executive Editor
Louis Landon

Joe Honcz
Todd Edgar
Ami Gopalan
Andrew Cournoyer
Jeremy Schafer
Louis Landon

Why Express Scripts’ Exclusion List for 2019 Is the Biggest Update Ever

Express Scripts just released its 2019 Formulary Exclusion list, marking a dramatic expansion in categories--including new disease areas thought too sensitive or rare to be managed by something as blunt as an exclusion list. In short, Express Scripts' new exclusion update is one of the most aggressive in years. Jeremy Schafer, SVP, Director, Payer Access Solutions, analyzes what the announcement means to payers.

Will American Patients First Deliver on Its Pledge?

What will the American Patients First initiative mean for payers? Will it deliver on lowering drug prices and improving affordability for patients? Andrew Cournoyer, Vice President, Payer Access Solutions, addresses these questions as he breaks down what we know and don’t know about the Trump administration’s recent announcement.

Oncology Coverage Policies: How to Help Payers Stay Ahead of the Scientific Curve

Janet Serluco, Vice President, Director, Payer Access Solutions, highlights the tremendous activity in oncology drug development. With 16 new oncology drugs approved by the FDA in 2017 alone, what strategies are payers adopting in future budget planning, and how do payers keep up with new oncology agents and expanding indications?

Survey Results: The Gene Therapy Revolution, Are Payers Ready?

Gene therapy has moved from the realm of science fiction to reality and is now likely to play a major role in how we will treat numerous diseases. Jeremy Schafer, SVP, Director, Payer Access Solutions, examines the promise of gene therapy and shares the results of a recent Precision for Value Rapid Pulse™ survey of payers and IDN decision makers on current and future challenges of gene therapy.