This blog post was originally published on ZS's pricing and access blog, The Price of Global Health.
Until recently, commercial success for a prescription drug mainly involved getting the drug on payer formulary and creating pull-through with sales force efforts toward physicians. Success was defined as securing full, unrestricted access and building significant share through share of voice. The rapidly rising cost of healthcare, new emerging pharmaceutical technologies with breakthrough potential, public concerns over drug pricing, and a gradual shift from fee-for-service to value-based payment models are transforming the pharmaceutical market. Today’s market is much more complicated, as public and private payer management is more restrictive, medical communities are more willing to engage in value vs. cost trade-offs, and providers are taking a more holistic and integrated healthcare delivery focus.
pharma commercial model,
Christina Corridon co-wrote this blog post with Pratap Khedkar.
Despite 16 approvals in the last four years, just six biosimilars currently are being marketed stateside. The U.S. biosimilars market hasn’t progressed as anticipated, yet some experts are wondering whether the biologic follow-ons can redeem themselves with a breakout year in 2019.
The U.S. biosimilars market has a tough road ahead. The WAC list price differential between biosimilars and the originator drugs is hovering around 30%, on average, which likely isn’t speeding biosimilars’ adoption in the U.S. Rather than playing the long game and waiting for the U.S. landscape to become more attractive, some biosimilar manufacturers like Momenta are choosing to exit the market. And others like Pfizer have shuttered their preclinical biosimilar programs to focus their efforts elsewhere. On the flip side, the Trump administration has zeroed in on drug pricing and biosimilars as priorities—and, of course, the two are intertwined.
Biosimilars Action Plan,
pharma drug pricing,
Prateek Yadav co-wrote this blog post with Christina Corridon, Tucker Herbert, Didier Chicheportiche and Gustavo Poblete.
The biosimilars market in Europe continues to generate buzz as it captures considerable market share from major blockbuster-branded biologics. Most recently, Celltrion's Truxima, a biosimilar of Roche's MabThera (rituximab), captured 32% market share in 18 European countries. Regulatory agencies have also welcomed biosimilars for the promise of the potential cost savings that they bring. Earlier, the U.K.’s National Health Service reported that switching patients from branded drugs to biosimilars and generics led to a savings of £324 million last year.
In the cat-and-mouse co-pay card game, payers have made their next move. Pharmacy benefit managers have been promoting “co-pay accumulator” programs to plan sponsors as a way to reduce specialty drug spending. Left alone, these programs will result in confused patients who are less likely to adhere to their medications, and high costs for pharmaceutical manufacturers. Pharma companies need to respond.
co-pay accumulator programs,
pharmacy benefit managers,
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.