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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Dangerous, Simple Drug Pricing Solutions

Posted by Ed Schoonveld on Thu, Mar 21, 2019

At a time when drug company CEOs are questioned in Congress and polarized U.S. Democrats and Republicans appear to unite in an intent to act on drug pricing, the industry needs to be very concerned. U.S. politicians and academics are exploring ways to satisfy public thirst for lower drug cost. The biggest danger in today’s Twitter world is the appeal of seemingly simple solutions such as a single-payer system, international price index, ICER and, recently, a three-part pricing model.


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Designing a Value Strategy

Posted by Ed Schoonveld on Thu, Mar 07, 2019

How do we use the access journey framework to design a winning value strategy in the age of value and affordability?


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Who Cares?

Posted by Ed Schoonveld on Tue, Feb 12, 2019

In my recent post, I described the underlying changes that are leading to today’s payer-empowered pharmaceutical environment. Now let’s consider the implications of these changes on the negotiation process.


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