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Specialty Pharmacies are Ready for the Biosimilar Boom. Are you?

The pharmacy benefit biologic market is primed for disruption, with Specialty Pharmacies (SPs) eagerly awaiting the pending market shift. While biosimilars have been available for nearly a decade in the United States, this year will be the first time many SPs begin dispensing these brands. Currently, 22 biosimilars are available in the U.S. and, up […]

Key Considerations When Operationalizing Revenue Management

Pharmaceutical manufacturers commonly invest a considerable amount of time, money and additional resources into revenue management. Most would likely say they desire to invest even more because of the significant impact it has on their products’ gross-to-net. But how and where to invest valuable assets is a significant decision. The process of revenue management, including […]

Informing Optimal Pricing Strategies with a Comprehensive Modeling Approach

Strategically pricing new therapies has always been vitally important for pharmaceutical manufacturers. After the 2022 passing of the historic legislative package, known as the Inflation Reduction Act (IRA), strategic pricing strategies have become especially pivotal. The IRA gives manufacturers less flexibility to adjust their pricing strategies due to penalties that are now applied for price […]

Case Study: Primary Research Meets Data-Driven Sources and Technology to Form Powerful Market Access Solutions

The case for primary market research, Real-World Data (RWD), and deep healthcare experience combined to deliver targeted market access strategies. As diseases become more complex and market access becomes more restrictive, with multiple sources of market research and data analytic solutions available, pharmaceutical executives are often overwhelmed with various sources of information. Leaders must learn […]

European Commission’s Long-awaited Pharma Legislation Review Gets Mixed Reception

NAVLIN Brief The European Commission has finally released its proposal to revise the European Union’s pharmaceutical legislation. The document includes proposals for a new Directive and a new Regulation, which revise and replace the existing pharmaceutical legislation via the largest reform in over 20 years The Commission proposes new incentives for AMR-related products, greater transparency […]

Left-Right-Left: The Latest in Pharma-Payer Ping Pong

Biopharmaceutical companies have offered financial assistance for commercially covered patients’ out-of-pocket (OOP) cost sharing for 20+ years. However, in the ongoing evolution of controlling versus encouraging patient access to specific drugs, payers and biopharma also have a long history of one-upmanship. Are pharma motivations for offering copay assistance centered on the patient, their own bottom […]

Peeking Behind the PBM-lead GPO Curtain

‘PBM-lead GPO,’ a Newly Created Term to Describe Large Scale PBM-Owned Rebate Aggregators PBM-led group purchasing organizations (GPOs) are not true group purchasing organizations in scope, nor are they pure rebate aggregators. Rather, PBM-lead GPOs are organizations formed by PBMs with one or more members, whose primary purpose is to aggregate purchasing volume to negotiate […]

Ready or Not, Biosimilar Adalimumab Brings the Heat in 2023

Anticipated Growth in U.S. Biosimilars Market U.S. payers and other healthcare stakeholders have eagerly awaited the launch of biosimilar alternatives to high-cost originator products as a new cost-control lever. However, much of the U.S. healthcare market has been frustrated by the sluggish incorporation of biosimilars into the marketplace, as compared to the notably smoother process […]

Case Study: Benchmarking Pathway-Specific Engagement with Health Plans & Organized Providers to Identify Best Practices

Tapping into primary market research and subject matter expertise can help uncover opportunities to more effectively meet their needs and position your brand for inclusion within their pathways.  As stakeholders seek to leverage oncology clinical pathways as a way to maximize patient outcomes and decrease costs, biopharmaceutical companies with pipeline and branded oncology drugs must […]

Payer Oncology Access Management in 2022

Payers balance the severity of disease with the need to control high-dollar utilization. As pharmacy spend continues to rise, payers are seeking ways to manage costs in the highest cost therapeutic areas, including oncology. While there is appetite to manage access for both oral and office-administered oncology agents, payers struggle with which tactics to implement without sacrificing patient […]

Launch Sequencing and Market Prioritization in an Evolving Global Market

The world is facing a multitude of governing and legislative changes that will directly affect pharmaceutical pricing in the coming years, with many of these changes exacerbated by the pandemic. As countries become increasingly interconnected, decisions in one pharmaceutical market will have ripple effects globally. Reasons for traditional launch sequencing include market size, opportunity and […]

Five Trends That Will Shape the Current and Future Payer Market Landscape

As leading payers build new business models to ultimately advance their approaches to care and drug management, biopharmaceutical companies need to adjust their account engagement and drug access strategies accordingly. Here are a the top five healthcare trends and payer tactics that our Health Strategies Insights team is watching. 1. Horizontal membership growth for business […]