What could be in store for the value and access landscape?

Posted by Richard Secker-Johnson on Tue, Apr 07, 2020

While the immediate impact of coronavirus on the pharmaceutical industry is evident, one area of uncertainty is how the virus will alter the landscape for the pricing and access of medicines in the longer term. Much of this impact will likely be linked to the macroeconomic effects of coronavirus, where we can speculate that changes in the size of economies as well as reprioritization of healthcare spending may alter payers’ ability and willingness to pay for medicines overall, and also for certain diseases and classes of medicine. However, another significant factor could be the impact of the virus on the value and access policy landscape. While there’s still uncertainty around how these policy changes could develop, we can look to some of the immediate global reactions to coronavirus that may serve as leading indicators of potential mid- to longer-term policy change.


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COVID-19: Now and Beyond

Posted by Ed Schoonveld on Tue, Mar 17, 2020

How does the COVID-19 pandemic impact the pharmaceutical industry and the drug pricing debate? In the short term, it may have caused a temporary break in the drug pricing media deluge, but it likely will create questions about new vaccine’s affordability and its ability to reach a broad patient population. As the disease’s spread continues to dominate the world stage, many pharmaceutical companies and university laboratories are working hard to identify treatment and vaccination options for COVID-19.


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Global Prescription Drug Costs: Why We Need Differential Pricing

Posted by Ed Schoonveld on Wed, Dec 18, 2019

The Trump administration is not the first government to explore the use of international price referencing to force drug prices down. This usually involves the institution of a price ceiling based on an average price for the same drug in a “basket” of other countries. The basket is supposed to consist of countries with similar income levels, but oftentimes that’s not actually the case. That’s just one of the many problems with international price referencing laws.


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A Tale of Two Patients: Who Will the Proposed Safe Harbor Regulation Most Benefit?

Posted by Pranava Goundan on Fri, Apr 12, 2019

Howard Deutsch and Kyle Harpole co-wrote this blog post, which previously published on The Active Ingredient.

The U.S. Department of Health and Human Services has proposed a new rule for safe harbor protection of drug discounts, effective Jan. 1, 2020. While the rule hasn’t been finalized, it has received more than 25,000 public comments, indicating that the current rebate model likely will be swept out to sea in favor of a model that aims to more directly address beneficiaries’ concerns about rising out-of-pocket costs. The percentage of patients whose out-of-pocket spending exceeds $2,000 nearly doubled between 2011 and 2015. The proposed regulation focuses on curtailing these costs by establishing, among other things, point-of-sale discounts for beneficiaries. We recently wrote about how pharma can prepare for the shifting seas of a new access and reimbursement landscape. In this post, we’ll compare two common Medicare Part D, non-LIS patient populations, diabetes and rheumatoid arthritis, to demonstrate how individual patients’ payment contributions would change under the proposed regulation.


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The Rebate Rules Are Changing. Here’s What Pharma Needs to Do to Prepare

Posted by Howard Deutsch on Tue, Mar 26, 2019

Pranava Goundan co-wrote this blog post, which originally published on The Active Ingredient, with Howard Deutsch.

In the classic political film, “The Candidate,” Robert Redford’s character, fresh off his victory, turns to his election strategist and asks, “What do we do now?” And the movie ends right there. The pharmaceutical industry now is facing a similar moment. After years of advocating for more transparent pricing and criticizing the rebate-for-access model for its perverse pricing incentives, pharma is on the cusp of partly getting its wish. But our movie doesn’t end there, so we must answer that question: What do we do now?


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