Value-based pricing and reimbursement models are not common in the United States, but this may change after recent programs by Pfizer and Takeda. These pricing strategies are based upon the value provided to the patient and have long been held back due to insufficient outcome data infrastructures. […]
Role of Pharmacy Benefit Managers Under Congressional Scrutiny
The role of pharmacy benefit managers (PBM) on patient out of pocket prices was examined by a US congressional hearing that began on November 17th. According to Brian Newell of PhRMA, PBMs negotiate rebates and discounts with drug companies to help patients pay less for medication than the list […]
Impacts of the Build Back Better Act on the Healthcare Industry
With the Build Back Better Act inching through the legislature, uncertainty is building regarding its effects on the healthcare industry. In Stat News’ D.C. Diagnosis newsletter, Nicholas Florko discusses how the included pricing caps will affect insulin manufacturers and other drug makers. In […]
Avoiding Medical Bankruptcy with Quizzify Prevent Consent Clause
Half of all Americans have outstanding medical debt, and the same number cannot afford a medical emergency. Bills for emergency medical care often incur 4-5 digit costs for payers or patients. However, according to Quizzify, including their 29-word “Prevent Consent” clause on your employees’ […]
Upcoming ICER Webinar Will Discuss Barriers to Fair Access
On December 3rd (12 PM), the Institute for Clinical and Economic Review will host a public webinar detailing the findings of their annual assessment of Barriers to Fair Access in major US payers’ prescription drug coverage policies. Presenters include Sara Edmond, Cat Ahmed, Rebecca Kirch, and […]
Insurance Design Harms Patient Health with Barriers to Access
Patient health is harmed by barriers to access caused by Insurance design, according to The Pharmaceutical Research and Manufacturers of America’s (PhRMA) first Patient Experience Survey. Results indicate that 41% of all patients report at least one instance of non-adherence, which increases as […]
JAMA Network Open Article Highlights the Plight of the Uninsured as Drug Costs Soar
A recent article published in JAMA Network Open highlights one major healthcare spending trend: the uninsured. An increase in concentration of spending on prescription drugs is growing and could result in widespread consequences. “The Patient Protection and Affordable Care Act has been associated […]
Xcenda HEOR Experts Discuss ICER’s UPI Assessments
Xcenda’s Tasmina Hydery and Anne Loos shared their thoughts on the methodologies used by the Institute for Clinical and Economic Review (ICER) in its Unsupported Price Increase (UPI) assessments. Payers are increasingly incorporating these ICER reviews in their coverage decision-making […]
[JAMA Article] New Oncology Drugs Command High Price Tags Despite Lack of Improved Survival
In an article published in JAMA Internal Medicine, researchers assessed the costs of 44 new oncology drugs. Surprisingly, they found that an increasing number of patients were receiving drugs without clear overall survival data. “The investigators suggested that the increased spending on cancer […]
ICER Releases Final Evidence Report for Hypertrophic Cardiomyopathy Drug
The Institute for Clinical and Economic Review (ICER) has published its Final Evidence Report for mavacamten, produced by MyoKardia and Bristol-Myers Squibb. The drug is used in patients diagnosed with hypertrophic cardiomyopathy (HCM). Panelists voted on the drug’s clinical effectiveness compared […]
