For decades, the pharma industry has been at the centre of an incessant debate: transparency in drug pricing. Pharma faces a perpetual paradox of compliance and standardisation on the one hand, and commercial sustainability on the other. Consequently, its drug pricing agenda rides a constant rollercoaster of scrutiny.
With rising treatment prices and healthcare spending, payer organisations are making efforts to contain costs, with the unintended consequence of putting up treatment access barriers. Hence, there is a growing interest in more innovative agreements, such as performance-based (reimbursements tied to conditions around producing outcomes or bridging evidence gaps), finance-based (rebates/discounts for excesses in agreed-upon […]
With the need to contain healthcare costs, payers often adopt selection criteria aimed at limiting the brands that are reimbursed and the price of those products. In some cases focus on cost containment can compromise patient access to new and innovative treatments. The need to establish a balance between cost containment and patient access pushes […]
Finding a cure for debilitating conditions is a long-standing aspiration for many working within the pharmaceutical industry. Indeed, when news broke out of a 15-year-old boy with Sickle Cell Anaemia experiencing 15 months without symptoms and routine treatment,1 interest in the curative potential of the novel gene therapy administered to the teenager increased. However, the […]
Thomas Mueller, Head of Pharmaceuticals at the Federal Joint Committee (G-BA), stated at the Pharma Pricing and Market Access Congress in London, February 2017, that the association of orphan drug status with high prices cannot continue and that the only way for orphan drug pricing to go is down. Yet, due to the small target […]
The number of unmet needs, whether clinical, economic or humanistic, remains high in oncology, especially for patients with metastatic conditions. With positive clinical trial results in many cancer types, including melanoma, colon cancer, lung cancer, Hodgkin’s disease, leukaemia, and others, immuno-oncology therapies are offering patients a new treatment alternative.1 Interest in immuno-oncology has been piqued […]
Discussions around risk-based managed entry agreements are growing, but only a few of these discussions come to fruition. Such agreements entail risks for both payers and manufacturers. Often, payers do not have the resources or capabilities to perform extensive risk evaluations and standardise value assessment across the board. Subsequently, many payers are sceptical of innovative […]
Governments have integrated incentives to accelerate and promote the approval of orphan drugs and the interest among pharmaceutical companies to develop these products is rising. However, expedited regulatory approval is by no means an assurance that orphan drugs will succeed in the marketplace.
Patients in the US often hear the term ‘drug formulary’ when they go to see their physician. A formulary, essentially, is a list of prescription medicines that are readily available in the hospital or that are covered by the patient’s drug insurance plan. The contents of formularies provide a strong reflection of the business priorities […]
In an effort to contain costs and avoid the over-valuing of products, payer organisations in the pharmaceutical and life science industries have made price setting a standard practice. One solution that potentially prevents over-valuation of medicines is External Reference Pricing (ERP). However, with greater amounts of data due to research and technological developments, increased adoption […]