A growing number of biologic medicines have been developed and approved over the past decade, improving the lives of patients worldwide.
Although these have been effective at treating numerous diseases, patient access has been limited, partly due to their relatively high cost. As biologics lose their patent-protection, many biosimilars are becoming available across Europe, and manufacturers are seeking to bring additional biosimilar products to market.
These are expected to bring with them the opportunity to generate competition for biologic therapies and thereby lower costs and increase patient access. However, some biosimilar policies and purchasing mechanisms limit participation of competitor products in specific markets, apply increasing price pressure or push physicians to switch patient product use.
These current dynamics have raised questions about the sustainability of the biosimilars market in the long-term.
Evidence-based care leads to better clinical outcomes, but how does it affect your cost?
A multi-year study performed in association with professionals from Abramson Cancer Center of the University of Pennsylvania and Johns Hopkins Carey Business School revealed that the cost of unwarranted components of oncology treatments averaged $25,579 per patient.
At current annual cancer incidence rates in the US, this translates to over $10 billion per year in unnecessary costs that could be significantly reduced by eliminating unwarranted, non-evidence-based cancer treatment.
Health economics and outcomes research (HEOR) and market access agencies provide specialist consultancy support to pharmaceutical and medical device companies throughout the lifecycle (early phase, pre-launch, launch and post-launch) of a technology (pharmaceutical drug or medical device).
The types of agencies that offer HEOR and market access consultancy support vary widely. They include medical communications (MedComms) agencies that offer these specialist services, and other companies that are dedicated exclusively to either HEOR or market access work (some provide integrated support across both disciplines).
In any of these agency types, as a medical writer working alongside team members with a wide range of skills, you will be involved in the generation and communication of evidence to demonstrate the added value of a technology, and its potential in clinical practice, to healthcare decision makers.
ConnectiveRx recently conducted a survey of over 250 prescribers to understand the potential prescribing impact of delivering in-EHR patient drug prices.
This white paper explores the key findings of that research and the potential impact on brand market share.
How does exposure to brand savings offers impact prescribing?
The challenges of managing prescription drug benefits continue to make today’s news. Headlines feature the hardships of soaring drug prices and the growing number of innovative drug approvals. As health care spending continues to outpace the economy, the need for changes in drug management intensifies.
This led Anthem Inc. to launch IngenioRx, a new pharmacy benefit manager (PBM) that will offer a full suite of services in 2020. The goal of IngenioRx is to improve health outcomes, reduce total health care costs, and provide consumers a simplified experience in a highly fragmented and confusing health care system.
IngenioRx will serve customers of Anthem’s affiliated health plans, as well as non-Anthem customers, with a seamless, consumer-centric approach to managing health and driving better outcomes. To accomplish this, clinical experts use integrated pharmacy + medical data and perspectives to guide decision making and effective use of traditional and non-traditional management tools. This allows us to achieve meaningful clinical outcomes at an affordable price. The ability to see the whole picture enables an examination of the total drug trend and provides insights and recommendations that go well beyond a traditional PBM.
With the launch of IngenioRx last year, we are proud to provide you with our inaugural annual drug trend report, detailing the 2017 consolidated pharmacy + medical drug trends for Anthem’s affiliated health plans, which will feature pharmacy benefits powered by IngenioRx beginning in 2020. We look forward to expanding and enhancing these strategies and solutions as we grow our pharmacy business within Anthem’s existing footprint and beyond.
The healthcare industry’s claims-payment system is frustrating to providers, payers, and patients alike. Inefficiency and a systemwide tendency for error wastes resources, worsens miscommunication and mistrust among all stakeholders, and inhibits the ability to transition to value-based approaches that achieve better outcomes.
Learn how the drive for accurate adjudication across the claims-payment continuum can optimize processes, reduce costs, align systems and stakeholders, and bring value-based payment models to scale.
With many payers focusing resources on a small percentage of chronically ill patients, a large portion of the member population remains unmonitored and engaged.
Patient engagement programs that are scalable, multi-layered, and tech-enabled to reach members in the most convenient and effective ways are essential to creating a positive member experience, driving loyalty, cost reduction, and better adherence.
As the largest payer of healthcare services in the United States, the Centers for Medicare and Medicaid Services (CMS) oftensets trend for healthcare delivery and reimbursement.
Over the past few years, there has been talk about Medicare reform and how to better pay for value. But we don’t always take the time to step back and appreciate what works well in Medicare and what has been emulated by other stakeholders.
For example, when Congress enacted the Average Sales Price (ASP) reimbursement methodology for Part B drugs in 2003, many commercial payers followed suit. This was with good reason: ASP is a transparent and stable metric that aligns reimbursement with market prices. Most recently, Medicare has again led the charge in adopting value-based reforms,creating ripple effects throughout the healthcare marketplace.
Four areas where we think Medicare has got it right are reimbursing physician-administered drugs, enabling beneficiary choice through Medicare Advantage, looking at total cost of care and tying payment to quality.
This paper is a companion piece to a detailed background paper on the use of real-world evidence in coverage decisions developed for the ICER Policy Summit held in December 2017.
This paper presents a new conceptual framework to address three elements largely missing from these earlier efforts focused on defining “best practices” or “standards” for RWE:
- How to understand the role that contextual factors play in determining how high the evidentiary standard, or “bar” will be in each situation;
- How to tailor key process and methodological approaches to the height of that evidentiary bar; and
- How to ensure that broader process principles that support transparency are integrated successfully throughout the course of any RWE initiative.
This guide lists the quality measure areas that can quickly and easily be impacted by mPulse Mobile solutions for each quality measure set and provides an overview of how these programs can be structured.