The massive pharmacy benefit manager (PBM) Optum Rx has launched its Price Edge tool that promises to lower generic prescription drug prices to patients. Price Edge scans through prices and pairs patients with the most affordable generic that matches their prescription. Purchases will apply to […]
Exploring Value-Based Drug Pricing Models
Value-based care, a kind of payment model that determines reimbursement based on patient care outcomes, has become more prevalent in recent years. Such a change has not been seen in prescription drug prices, despite the advent of multi-million dollar therapies that can radically change a patient's […]
Uncertainty Surrounds Payment Models for World’s Priciest Therapeutic
With the US Food and Drug Administration’s (FDA’s) approval last year of Hemgenix, a hemophilia B gene therapy by CSL Behring and most expensive drug in history, insurers are looking to the Centers for Medicare and Medicaid Services (CMS) for new payment models. The agency has long […]
End of the X Waiver for Buprenorphine
Patients seeking buprenorphine, a partial opioid used to successfully treat opioid dependency and reduce overdoses, have classically had to get an waiver to get the drug in the US. This requirement, which effectively limited access to the lifesaving medication, is being lifted today as part of the […]
Sanofi Sets Up Warranty Program for Discontinued Rare Disease Treatment
Sanofi has set up a warranty program to pay back some medical institutions who administered Cablivi, an antibody-based treatment for a rare clotting disease. The company will reimburse healthcare institutions the cost of 6 doses for patients who do not see improvements and 12 doses for patients […]
Oncology Telehealth Cuts Costs for Some Patients
A newly published paper in JAMA Network Open shows that some cancer patients saved significantly on travel costs by using telehealth oncology services. The study looked at completed telehealth visits from 11,688 adult patients up to 65 years of age and analyzed travel costs and loss of productivity […]
Pharma Bro Martin Shkreli in Hot Water with FTC Over Lifetime Industry Ban
Martin Shkreli is once again in trouble with the FTC, this time over a potential violation of his lifetime ban from the pharma industry. Shkreli, who famously jacked the price of a niche malaria medicine from $18 to $750 per pill, appears to the agency to be side-skirting his industry ban for […]
In-Person Care and Telehealth Private Insurer Payments Similar in 2020
A new analysis by the Kaiser Health Foundation finds that reimbursements from private insurance plans were similar for in-person and telehealth appointments during 2020. The researchers analyzed data from over 90 million claims. The average cost for telehealth visits covering serious evaluation and […]
JAMA Network Study Shows Quality of Care Doesn’t Mitigate High Out-Of-Pocket Healthcare Costs
A newly published study in JAMA Network has found that no matter whether the quality of care for emergency general surgery (EGS) is good or subpar, the out of pocket (OOP) costs are uniformly high. The researchers looked at 23,450 patients admitted for several common causes of EGS at over 600 […]
NAHC President Tells Home Care Providers to Keep an Eye on Medicare Advantage
At a webinar this week, the president of the National Association for Home Care & Hospice (NAHC) Bill Dombi said that Medicare Advantage plans are on the rise and that home care providers should pay attention. Dombi noted that there is a huge marketing force driving the boom, with big celebrity […]
Promoting Health Equity Efforts in Sub-Saharan Africa Via Social Entrepreneurs
Biotechs and pharma startups popped up across Africa during the COVID-19 pandemic, with so-called social entrepreneurs taking the lead. The World Economic Forum recent published a report on innovations driving health equity efforts in sub-Saharan Africa, highlighting the role of social […]
Crescendo Health Gets $3.4 Million to Support Clinical Trials with Real-World Data
The startup Crescendo Health has announced it received funding totalling $3.4 million to expand its real-world data (RWD) offerings. The company launched a platform that allows researchers and clinicians to integrate healthcare data from electronic health records (EHR), payer records, pharmacy […]
BioPharma Dive 2023 Biotech Executive Outlooks
In a new BioPharma Dive panel hosted at this year’s J.P. Morgan Healthcare Conference, executives from ABIO-X, Ovid Therapeutics, and Lifemine Therapeutics spoke about their projections for the new year. Their outlook was somewhat tempered by the current down market and prospects of drug pricing […]
Examining Political Determinants of Health
Social determinants of health (SDoH), characteristics like race, ethnicity, socioeconomic status, geographical location, and housing status, have been increasingly recognized as contributing to health outcomes. However, another set of factors affecting health outcomes are political determinants of […]
Real-World Data Study Shows Letrozole and Palbociclib Combo Effective for Black or Hispanic Breast Cancer Patients
Although frontline letrozole and palbociclib combination therapy did not improve survival for patients with estrogen receptor-positive, HER2-negative, advanced breast cancer in clinical trials, Black and/or Hispanic patients saw an increase in progression-free survival and overall survival. Dr. Adam […]
Inflation Might Have a Good Side? – Managed Healthcare Executive State of the Industry Survey
In its latest annual State of the Industry survey, Managed Healthcare Executive found that many respondents saw there could be a good side to inflation for the healthcare sector, despite its many negative effects. Many predict layoffs, decreases in care, increased spending, and costs being shifted […]
Verana Health Publishes Real-World Data Ophthalmology Study Replicating Phase III Trials
Verana Health has announced the publication of its research in Ophthalmic Surgery, Lasers and Imaging (OSLI) Retina. The study used de-identified real-world data (RWD) and replicated two phase III trials for the use of Regeneron in wet age-related macular degeneration, making it the first of its […]
Involving Doctors in Hospital Governance Reduces Burnout and Improves Patient Outcomes
The Australian Medical Association (AMA) has released a new position statement promoting the involvement of doctors in hospital governance. The organization notes that doing so will help improve workplace cultures and thereby improve patient care and subsequent health outcomes. Moreover, their […]
CMS Examines Coverage Options for HIV PrEP Preventative Care
A new analysis has been launched by the US Centers for Medicare and Medicaid Services (CMS) to evaluate the nationwide coverage of HIV preexposure prophylaxis (PrEP), a group of antiretroviral drugs that prevent HIV infections and transmission when taken appropriately. The drugs, which hover at […]
FDA Defends Decades-Old Abortion Pill Approval Decision Against Conservative Challengers
A group of conservatives called the Alliance for Hippocratic Medicine challenging the approval of mifepristone, a pill used for safe abortions, has met resistance from the US Food and Drug Administration (FDA). The group and other far-right activists claim the agency rushed the drug’s approval and […]
Patient Advocacy Groups Butt Heads with CMS Over New Alzheimer’s Drug Coverage
With the accelerated approval of lecanemab, Eisei and Biogen’s new Alzheimer’s drug, patient advocacy groups are gearing up for another fight with the US Centers for Medicare and Medicaid Services (CMS) over the agency’s previous decision not to cover drugs in its class unless patients are enrolled […]
Ipsen CEO Talks Rare Disease Therapeutic Development and the Risks of Gene Therapy
David Loew, CEO of Ipsen, spoke at the JP Morgan Healthcare Conference about his outlook on the rare disease field. Loew noted that Ipsen was leaning into the market full-steam, regardless of pressure from Big Pharma companies attempting to crowd the space. That said, the CEO was more cautious on […]
Increasing Access to New Medications for Patients Across Africa
Africa deals with a disproportionate disease burden but patients throughout the continent have less access to new therapeutics than their peers in wealthy western nations. In a new IQVIA article, Mridu Bhutani discusses some of the underlying causes of this health inequity and covers ways that […]
NHS Confederation and ABPI Report Recommends Collaboration to Increase Access to Innovative Therapeutics
A newly published report from the NHS Confederation and Association of the British Pharmaceutical Industry (ABPI) indicates that collaboration between the NHS and pharma can help improve patient access to innovative treatments. The report noted that uptake of novel therapeutics was often stunted by […]
Nature Medicine Perspective: Next-Gen Evidence-Based Medicine
The recent wave of digital health solutions, data analytics, and artificial intelligence (AI) is driving the newest generation of evidence-based medicine, according to a Nature Medicine perspective by Vivek Subbiah. These technologies are empowering novel clinical trials that utilize real-world […]
AstraZeneca Collaborates with Qure.ai for AI-Based Lung Cancer Diagnosis Pilot Trial
AstraZeneca has announced a new team-up with Qure.ai and a UK-based clinical team in a pilot trial to test the diagnostic capabilities of Qure.ai’s qXR software in identifying lung cancer from X-ray images. The trial will be held in clinics in Greater Manchester, which is noted for having some of […]
Pfizer and China in Deadlock Over High Paxlovid Price Amid COVID Surge
As China struggles with a massive surge in cases following the end of its COVID Zero policy, the nation’s officials are at odds with Pfizer over the cost of its COVID-19 pill Paxlovid. Critics of big pharma argue that the middle of an outbreak is not the time to be playing hardball, but […]
Zerenia Clinic Receives First NHS Reimbursement for Cannabis-Based Treatment
Zerenia Clinics has achieved a new milestone for by receiving full reimbursement from the UK’s NHS for costs related to cannabis-based treatments. The company, owned by Khiron, noted that the reimbursement is their first of its kind for outside clinics that specialize in cannabis-based products for […]
FDA – Last Week in Review
Last week, the US Food and Drug Administration (FDA) made key decisions regarding the approval of multiple medications and accepted submissions of a few others. First, the agency approved the use of semaglutide as a first-line diabetes therapy. In addition, it accepted the application for […]
Pharma Industry to Continue Facing Inflationary Pressure Through 2023
High inflation rates will continue battering the pharma industry throughout 2023, according to a new Pharmaceutical Technology article. Although inflation appears to be abating in the US this year, it may fall more slowly abroad, impacting growth. In addition, drug pricing reform in the US weighs […]
