Compass is the place for us to share our thoughts and opinions about market access, health economics, and policy issues.
Health and Human Services (HHS) is proposing to eliminate safe harbor protection for manufacturer reductions in price on prescription pharmaceutical products to Medicare Part D plans, PBM’s, and Medicaid Managed Care Organizations.
In conjunction with this amendment, HHS is proposing new safe harbor protections which would protect manufacturer point-of-sale (POS)…
MOREThe Institute for Clinical and Economic Review, a non-profit institute evaluates the cost-effectiveness of drugs, medical devices, medical procedures, and diagnostics. The Institute for Clinical and Economic Review has published multiple assessments of healthcare technologies which provide a volume of evidence to better understand the quantitative conclusions by each evaluation…
MOREMarch 24, 2018 | Lopamudra Das, Brian Duffant, Courtney Coles
Chimeric Antigen Receptor T-cell (CAR-T) therapies represent a breakthrough in cancer care due to the significant clinical response induced in patients who do not respond to currently available treatments. In 2017, two CAR-T therapies were approved by the FDA –…
MOREMany life science manufacturers employ a payer size and control strategy in the US market. While this continues to be viable model, changes in formulary and benefit design result in local-level access variation. This suggests that alternative strategic approaches are important to consider when manufacturers engage in market access planning.
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MORENew drug coverage policies provide guidance around a payer’s coverage of new drugs in the time period between FDA approval and P&T committee review. As these policies proliferate, manufacturers may find initial new drug launch access to be more limited than anticipated.
Key Findings
Commercial and Medicare Part D payers…
MOREPayers who offer Medicare Part D plans may receive additional compensation after the point-of-sale. These funds are known as Direct & Indirect Remuneration (DIR), and account for growing levels of disparity between Part D gross and net drug costs. As DIR is primarily composed of manufacturer rebates on select drugs,…
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