For quite some time, providers, public and private payers, policy-makers, pharmacy benefit managers and patients have hoped the arrival of biosimilars would usher in a new era of competitive drug prices. However, as the U.S. market prepares to welcome its second biosimilar, Celltrion’s Inflectra, the future of biosimilars in this…
The healthcare industry is facing enormous pressure in the form of spiraling cost inflation, lagging quality indicators, rising insurance premiums, and increased demand for price transparency to deliver better health outcomes at lower prices. The historical fee-for-service business model that rewards the volume of treatments and encourages unnecessary care without…
It’s no secret that the global healthcare industry is increasingly challenged to reduce costs while still delivering innovative, high-quality care. This transition toward a value-based framework for healthcare delivery and payment is the driving force behind today’s rapidly changing healthcare landscape. In past columns, I’ve discussed the growing importance of…
Imagine buying a new car only to learn that it doesn’t work as advertised and there’s nothing you can do about it. That’s essentially what happens when you take a pricey medication or need an expensive medical device like a heart valve or new knee — there’s no guarantee it…
On the morning of April 1, hospital and medical device company executives woke up to yet another new chapter in bundled pricing — CMS’ Comprehensive Care for Joint Replacement (CJR) initiative. Unlike the Bundled Payments for Care Improvement (BPCI) programs that preceded it, there is no opt-out clause for the…
With spiraling costs and outcomes that consistently lag many other developed nations, the U.S. healthcare system is in the midst of fundamental change. In response, payers have been exploring ways to restructure payments (and risk) to increase accountability for cost and quality. Thus far, most activity has occurred between payers…
