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The Active Ingredient features expert insights and commentary from leaders of ZS Associates' global pharmaceuticals practice.

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Two Blocked Payer Mega-Mergers and the Future of the Health Insurance Market

Posted by Paul Darling on Mon, Feb 27, 2017

Just weeks ago, a looming merger between two major health insurance companies threatened to alter the health insurance market’s competitive landscape. The $54 billion deal between Anthem and Cigna was blocked by a federal judge in early February, on the same grounds as a $37 billion deal between Aetna and Humana that was blocked in January. According to the judges’ rulings, both deals would have reduced competition and increased prices.

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Topics: health insurers, Pharma, Life Sciences, Humana, healthcare ecosystem, Paul Darling, payers, Anthem, Aetna, Cigna, mega-mergers, UnitedHealth Group

Transitioning Pharma to Value-Based Payments Will Require More Than Corporate Collaboration

Posted by Paul Darling on Tue, Mar 01, 2016

Healthcare reimbursement in the U.S. is undergoing a fundamental transformation. The Center for Medicare & Medicaid Services has led this transformation, announcing that 50% of all Medicare payments will shift from fee-for-service to alternative payment models by 2018. Pharmaceuticals have been entirely omitted from these plans, as Medicare is legislatively prevented from negotiating drug prices. Hence, manufacturers and private payers are expected to play a dominant role in determining payment models that reimburse pharmaceutical manufactures for value in the form of patient outcomes, rather than the pills, themselves.

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Topics: Paul Darling, payers, outcomes, ecosystem, Anthem, Health Affairs, Lilly, value-based payments, regulations

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