Currently Viewing:
The Academy of Managed Care Pharmacy (AMCP) 2018
Specialty Drug Pipeline Review Focuses on Competition, Cancer Drugs
April 24, 2018
Dr Robert Navarro Discusses Progress in Shift to Value-Based Care
April 24, 2018
Brian Litten Outlines How Medication Therapy Management Can Address Opioid Misuse
April 24, 2018
Who Decides What Value Looks Like in US Healthcare?
April 24, 2018
Dr Brandon Newman Discusses Payer, Academic Medical Center Collaboration
April 25, 2018
Dr Aimee Tharaldson Discusses Key Market Trends in Specialty Pharmacy
April 25, 2018
Migraines in the US Are More Than Just a Pain Problem
April 25, 2018
Currently Reading
Market Access Teams Face New Challenges in Pharma
April 25, 2018
Dr Somali Burgess on the Role of Patient-Reported Outcomes in Managed Care Pharmacy
April 26, 2018
Dr Tina Joseph Discusses Collaborative Practice Agreements Between Pharmacists, Physicians
April 26, 2018
Navigating the Rocky Waters to Value-Based Healthcare
April 26, 2018
Hemophilia: Treatment Landscape, Costs, and Disease Management
April 26, 2018
Dr Aimee Tharaldson on Recently Approved Specialty Drugs, Upcoming Approvals to Watch
May 05, 2018
Dr Calvin Knowlton Outlines Benefits Seen From Enhanced Medication Therapy Management
May 06, 2018
The Rise of Orphan Drugs for Rare Diseases
May 07, 2018
Dr Robert Navarro Foresees Unintended Consequences From Shift to Value-Based Care
May 12, 2018
Dr Kimberly Lenz: Identifying Patients Most at Risk For Substance Abuse
May 13, 2018
Brian Litten Outlines Challenges With Adopting Medication Therapy Management Services
May 17, 2018
Dr Tina Joseph Outlines Pharmacists' Role in Managing Chronic Diseases, Value-Based Care Models
May 19, 2018
Dr Calvin Knowlton on Innovative Practices in Enhanced Medication Therapy Management
May 20, 2018
Dr Ashley Pappas Discusses Collaboration Between Academic Centers and Payers
May 24, 2018
Dr Robert Navarro on Pharma Implementing Value, Best Practices for Value-Based Contracts
May 25, 2018
Drug Approvals That Dr Aimee Tharaldson Is Keeping an Eye on for 2019
May 27, 2018
Dr Kimberly Lenz on Implementing, Enforcing Appropriate Opioid Prescribing
June 04, 2018

Market Access Teams Face New Challenges in Pharma

Allison Inserro
There are 6 key issues that market access teams are facing amid evolving marketplace trends in the pharmaceutical industry, said Douglas Long, BS, MBA, vice president, industry relations, IQVIA, when speaking at the headline session of the Academy of Managed Care Pharmacy’s Managed Care & Specialty Pharmacy Annual Meeting held April 23-26, in Boston, Massachusetts.
There are 6 key issues that market access teams are facing amid evolving marketplace trends in the pharmaceutical industry, said Douglas Long, BS, MBA, vice president, industry relations, IQVIA. Long spoke at the headline session of the Academy of Managed Care Pharmacy’s Managed Care & Specialty Pharmacy Annual Meeting held April 23-26, in Boston, Massachusetts, talking about 2017-2018 Pharmaceutical Marketplace Trends.

IQVIA, formed from the merger of IMS Health and Quintiles, recently released a report called Medicine Use and Spending in the US: A Review of 2017 and Outlook to 2022, and Long spoke about that first to a packed audience.

He said spending on all US medicines rose 0.6% to $324 billion on a net basis because of greater generic volume. There are also larger manufacturer discounts and increasing coupon use.

Indicating that there is generic price inflation, Long said that generic dollar sales have declined for 21 consecutive months, and 16 of top 20 generic companies had negative dollar decreased sales and growth over the last 12 months. There is also consolidated buying power in the generic marketplace.

Last year, spending grew 0.6% net of off-invoice discounts and rebates as growth slowed to 1.4%. Overall, spending reached a total of $453 billion on a gross invoice basis but $324 billion on a net basis. Growth on specialty drugs outpaced traditional drugs and now has 43.3% of the total now discounted spending. Last year, specialty spending grew at 9.4% while traditional spending fell 4%.

Discounts, rebates, and other price concessions on branded medicines reduced absolute invoice spending by an estimated 28% to $324.4 billion.

Retail prescription drugs accounted for $212 billion in net spending for the year, reflecting a 2.1% decline from 2016.

By therapy class, the 3 largest areas are hypertensives, mental health, and diabetes, accounting for 55% of prescription growth over 5 years, while pain medicines declined, Long noted.

Hypertension is the largest therapy area by drug volume, and it affects nearly one-third of Americans. New guidelines recommend treating nearly half of the population, which could further increase the volume.

In specialty drugs, the top 5 biggest areas are diabetes, oncology, autoimmune, respiratory, and HIV.

There has also been an increase in patient use of medicines with 90-day prescriptions, which Long said increases adherence, especially for the treatment of chronic conditions. One of the drivers of this is Medicare Part D, but the same is not true for Medicaid, where it is far less common, because of patient churn.

Looking ahead, Long said there are 6 challenges for market access:
  • Managed care organizations and pharmacy benefit managers are increasingly using strict approaches to manages drugs, including formulary exclusions.
  • Patient face higher out-of-pocket payments—the average commercial co-pay increase rose 14% between 2016 and 2017. The percentage of patients with deductible plans are rising, as are new plan designs that shift more costs on to them.
  • There is increased public pressure for price scrutiny and transparency. State legislatures have responded with an increasing number of bills since 2015, targeting list prices, maximum allowable price, or net price disclosure.
  • Medical benefit drugs will no longer be protected in an era of vertical intergration and increased medical management techniques.
  • Value frameworks are expanding influence, such as organizations as the Institute for Clinical and Economic Review, and value based payment models are increasing.
  • The provider landscape is shifting with new accountable care models and integrated delivery networks.


Related Articles

Link Between Rising Generic Drug Prices and Market Competition Levels
Health Systems to Address Drug Costs With Formation of Nonprofit Generic Drug Company
Healthcare Spending Driven by Price, Not Utilization: JAMA Study
Who Decides What Value Looks Like in US Healthcare?
Dr Aimee Tharaldson Discusses Key Market Trends in Specialty Pharmacy
 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up