Pharma Insights

Insights from payers and health systems shed light on drivers of the interest in value-based contracting, important barriers to implementation, and implications for manufacturers seeking to engage in successful value-based agreements.
As initial gene and cellular therapies come to market, debate is growing as to the best ways to evaluate the associated economic impact, specifically in the context of the shift to value-based reimbursements.
With the arrival of clinically validated software technologies designed to treat disease, or “digital medicines,” comes a plethora of uncertainties related to how stakeholders will value these products relative to traditional medicines and how they will fit into today’s health care system.
Our analysis across multiple tumor types has demonstrated that health systems are wielding a growing influence on how care is delivered in the local markets in which they operate.
The European Medicines Agency approved its first biosimilar product in 2006; the United States biosimilar market remains in its infancy. The United States must look to the European Union as biosimilar adoption continues to grow.
New drugs for orphan and rare diseases have the potential to positively impact the lives of patients where historically few or no treatments had been available to manage the disease.
Annual updates to formulary exclusion lists suggest a need for careful evaluation by benefit sponsors, clinicians, patient advocacy groups, and the pharmaceutical industry to determine implications on treatment outcomes and achieving value-based care.
Dr Larry Blandford, PharmaD, provides a discussion of discounts, management approach, and expected challenges of the biosimilar era.
Value measurement strategies and managed care may serve to reconcile the rapid treatment advances occurring in oncology with the attendant high costs of care.
Alternative management approaches, including clinical pathways, should be considered to allow payers to facilitate transitions of care while practicing antimicrobial stewardship.