With the migration of employers out the fully insured market, there’s a new sheriff in town: The purchaser is the payer. The Midwest Business Group on Health is mounting an unprecedented effort to help employers take charge of specialty drug management.
In a system of healthcare financing that largely doesn’t work for specialty drugs, the Midwest Business Group on Health is leading an ambitious initiative to educate and empower employers. The project’s scope and potential outcomes are unprecedented.
PMCID: PMC3524739
PMID: 23267279
Helping payers track advanced diagnostics is a must in a health reform environment
PMCID: PMC3524740
PMID: 23267285
After 30 years of research, ADCs are finally making it to market — with more on the way.
Next generation antibody-drug conjugates, like T-DM1, are meant to kill the cancer – not the patient.
PMCID: PMC3524741
PMID: 23267283
PMCID: PMC3524742
PMID: 23267278
Motivational interviewing is a tool for changing patients’ medication-taking behavior.
For patients, poor adherence to biologics can increase risks of morbidity and mortality. For payers, it means money down the drain. Here’s a tool that proponents say can help change patient behavior.
PMCID: PMC3524743
PMID: 23267280
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PMID: 23267284
New therapies may be truly disease-modifying. Tighter payer management may follow.
For so long, multiple sclerosis has frustrated physicians and patients. With bold new treatments on the way, payers are thinking about tighter management. Formal treatment guidelines would help. Bio-markers could also sort out the ‘right-drug, right-patient’ conundrum.
PMCID: PMC3524745
PMID: 23267282
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PMID: 23267276
The need to invest in the regulatory environment to support biotechnology innovation is urgent, says Jim Greenwood, president and CEO, Biotechnology Industry Organization
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PMID: 23267286
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PMID: 23267277
It depends on the direction of immunotherapy research and the choices society makes.
Immunotherapy vaccines could extend survival in a handful of cancers. But personalizing treatment, payers argue, is not sustainable. Where should the line be drawn?
PMCID: PMC3524749
PMID: 23267281
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PMID: 23091432
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PMID: 23091434
When the integrity of genomics research is questionable, the quality of downstream clinical trials suffers. After Duke’s folly, the Institute of Medicine took a preventive step.
Using genomic tests to personalize oncology treatment is a worthy endeavor. But when the rush to capitalize on biomedical research overcomes the rules of evidence, it’s the patients who suffer.
PMCID: PMC3474449
PMID: 23091430
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PMID: 23091435
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PMID: 23091424
No matter how CER is sliced, cost will be a factor. But, first, how to gather the right data?
Autonomy, innovation, and drug access may be at stake along with personalized medicine. Can all stakeholders be satisfied and should cost be a factor?
PMCID: PMC3474453
PMID: 23091431
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PMID: 23091426
The messy story of UPMC and Highmark’s attempt to integrate is a case study of how competition can get ugly. The lessons for payers, providers, and patients are also relevant for biotechs, whose business approach will have to change as their customers change.
Healthcare reform is encouraging the vertical integration of payers and providers. How far can this go in any one market before such efforts risk being deemed illegal? Pittsburgh provides a case study.
PMCID: PMC3474455
PMID: 23091428
The growth of specialty drug use is shaking up distribution channels and offering business advantages that retailers want to grab. Second of a two-part series.
Previously, this series described distribution channels through which specialty drugs move to patients. This installment discusses changes and challenges that lie ahead, especially at the dispensing end.
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PMID: 23091429
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