With spiraling cost inflation and outcomes that lag many other developed economies, the US government’s healthcare insurance authority (CMS), is driving reform aimed at better quality and lower cost, and private payers are following suit. Both state and private payers are moving toward alternative payment models, like value-based payments, that…
As payers and providers continue to explore ways to reduce healthcare spending and improve patient outcomes, there is a growing trend to require more evidence of product safety and effectiveness across the product lifecycle. For manufacturers, the failure to develop such data can result in reduced formulary access and lower…
Over the past few years, the war on drug prices has intensified and been marked by a series of signal events—for example, oncologists publically refusing to allow a pricey new therapy such as Sanofi’s Zaltrap on their formulary, and pharmacy benefit managers (PBMs) (e.g., Express Scripts) and governments (e.g., the…
Canada remains the ninth largest pharmaceutical market in the world, close to Spain and the United Kingdom. Drug makers operating in Canada have benefited from high per capita spending on pharmaceuticals and rising procurement as a result of the country’s aging population. In 2014 alone, the country spent an estimated…
In a recent move that garnered considerable attention, Express Scripts, one of the largest pharmacy benefit managers (PBMs) in the US, announced a plan that would link the price of some cancer drugs to their real-world performance.1 Although this isn’t the first time that an alternative pricing model for drugs has…
Long taken for granted, premium oncology drug pricing is coming under fire. Payers are experimenting with new tools to manage oncology costs. Emerging reimbursement models separate physician income from prescribing decisions. Providers, payers, and patients are increasingly asking about cost-effectiveness, quality of life, and outcomes. Are you ready for the…
