Dr. David Reese; Business Insights Analyst

Opioid Epidemic Spawns Flurry of PBM Programs to Address Abuse

Express Scripts, other major PBMs tighten controls on opioids Abuse and overuse of opioids continues to be a hot topic as lawmakers and healthcare industry stakeholders take aim at programs to combat the epidemic. According to the Centers for Disease Control and Prevention, most overdose deaths involve an opioid and deaths from prescription opioids have […]

Direct-to-consumer: New avenue for PBMs could provide political shelter

Departing from their traditional role working for payers as third-party administrators of prescription drug coverage, two of the largest pharmacy benefit managers are taking a direct-to-consumer approach through drug discount programs.   The discount cards (also known as consumer cards, point-of-sales cards, or 100 percent copay cards) bypass the payers that PBMs typically serve, disrupting […]

Hot Topics at ASCO 2017 – Part 2

ASCO 2017 is nearly upon us, so here is the second of our blogs covering key data that will be released, this time in the latter part of the conference. As before, don’t forget to use our handy guides below on how to get around to these presentations while you’re there.   Results of adjuvant […]

CBO Score of AHCA Offers Few Surprises, Pegs 23M Loss on Insurance Rolls

The new Congressional Budget Office on the American Health Care Act looks remarkably similar to the old score, and still creates major conundrums for the U.S. healthcare industry. The CBO estimated 23 million fewer insured Americans by 2026, down slightly from the 24 million project under the original AHCA. Elimination of the Affordable Care Act […]

Don’t Expect House Health Reform to Move Far in Senate

When does a Congressional bill move forward but not possess much in the way of forward momentum? That will grow apparent as the American Health Care Act moves to the Senate. With a 217-213 vote, the U.S. House on May 4 passed the American Health Care Act (AHCA), the Republican replacement for the Affordable Care […]

Teva Nabs First True Generic Salmeterol/Fluticasone Propionate Launch in the United States, While GlaxoSmithKline Keeps its Cool

Teva recently launched the first true generic salmeterol/fluticasone propionate for asthma in the United States, but in a surprise twist, the generic is an authorized generic to Teva’s own “branded-generic” salmeterol/fluticasone propionate, AirDuo RespiClick, and is not directly substitutable with GlaxoSmithKline’s Advair. It was a clever move on Teva’s part to get approval for a […]

Health technology gadgets – good, bad or transformative?

Digital innovations and their adoption, specifically health related gadgets, could indicate a shift to consumers becoming the key opinion leaders of their own healthcare. Is a big change coming? Personally I love tech and can easily be absorbed by a new development idea that challenges the tech of yesterday. I remember, many years ago now, […]

Outcomes-Based Contracting Gain Steam

Amgen’s recent offer to refund to health plans the cost of its statin add-on therapy Repatha for eligible patients who take it and then suffer a heart attack or stroke highlights the extent pharmaceutical companies are willing to go to overcome insurance access barriers to expensive, groundbreaking therapies. The refund offer was announced along with […]

ACC.17: a roller coaster of results

ACC is done for another year, with a multitude of exciting trials presented, including FOURIER, EBBINGHAUS, SPIRE-1 and -2, ORION-1, and CARAT. There were negative as well as positive results, making for a very interesting meeting and some important scientific breakthroughs. Let’s start with the positive. The results from FOURIER, the cardiovascular outcomes trial for […]

Post-grant oppositions for pharma patents (Part 3): A look at potential strategies

In FY2016, the percentage of patents that were found to be valid in the PTAB’s final written decision for the biopharma sector was quite high (~34% valid vs. 39% invalid), relative to other industries (AIA Trial Statistics, https://www.uspto.gov/sites/default/files/documents/aia_statistics_november2016.pdf, accessed March 8, 2017). A well-planned strategy will help both a petitioner and patent owners (POs) maintain […]