Formulary Insights

A better path to payer insights

Last year, a marketer with two decades of big pharma experience joined one of the healthcare industry’s many emerging biotech startups. With a promising new drug in Phase III and venture capital funding well in hand, he embraced this opportunity as his career capstone.    The payer launch plan he inherited appeared comprehensive, but the […]

Biopharma leaders prepare to navigate Medicare’s new negotiating power

The importance of the Medicare market to biopharma’s success in the United States cannot be overstated. The Centers for Medicare and Medicaid Services (CMS) reports its enrollment is more than 60 million Americans,1 and its annual Part B and Part D drug spending exceeds $237 billion.2 Given Medicare’s importance to manufacturers, any legislative changes to this government program […]

Will your clinical trials deliver the leverage you need with payers?

Biopharma manufacturers struggle to communicate the clinical value of their medicines to payers for many reasons: payer drug evaluations are conducted in secrecy, promotional messaging to payer P&T committee members is largely prohibited, and rebate negotiations dominate manufacturer-payer engagements. These challenges are further compounded by the payer community’s legions of pharmacist drug evaluators declaring a […]