Andrew discusses two unintended consequences of the resulting from the Inflation Reduction Act (IRA). In this article, Andrew highlights the IRA’s small manufacturer exemption that aims to provide financial protections, yet could actually imposes access obstacles. Additionally, he details how the Medicare Part D redesign has negatively impacted plan offerings and its resulting effect on beneficiary choice.
American author H.P. Lovecraft wrote that “the oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.” And unknown territory is where we are heading when it comes to forecasting payer actions in response to the impending liabilities and costs stemming from the Inflation Reduction Act. What we know for sure, however, is that payer liability is increasing.
When you squeeze a sealed balloon on one end, the air doesn’t simply go away; rather, it just finds another part of the balloon to expand. In other words, the air must go somewhere. The Inflation Reduction Act will create a similar dynamic with drug costs for Medicare payers and drug manufacturers.
The inauguration of President-elect Biden will mark the end of a tumultuous 4-year run of the Trump Administration’s failed attempts to overturn the Affordable Care Act (ACA) and find a solution to meaningfully lower drug costs for all. Andrew Cournoyer examines how national health plans may react to Biden’s goal of affordability.
While 2020 first quarter earnings fell short for many companies and industries, many national health insurers actually exceeded initial expectations. A common theme in each of these cases was that the PBM was cited as the driver of growth. Andrew Cournoyer discusses the viewpoint of a national health plan with an eye on maintaining positive adaptations in a COVID-19 world.
From quarantine and stay-at-home orders to businesses being closed, daily life has pivoted considerably to being digital in nature. Precision’s Andy Cournoyer discusses the findings of a new AET survey on virtual engagement and understanding payer preferences for obtaining information and interacting with drug manufacturers in the current environment.
Manufacturer drug pricing has been and will continue to be a key focal point on political agendas. But as proposed legislation is blocked or stymied, will there be any room for advancement? Andy Cournoyer discusses potential roadblocks, opportunities for innovation, and what they mean for payers in 2020.
Access Experience Team member Andrew Cournoyer looks at national health plans and the growing trend toward vertical integration and management of drugs covered under the medical benefit.
Andrew Cournoyer outlines recent Medicare regulatory changes likely to influence formulary offerings and emphasizes the trend toward patient affordability and drug pricing in 2020 formulary design.
Drug costs are a main concern for both government and commercial payers. In 2018, CMS tackled drug costs in Medicare through several measures. Will the trend continue in 2019? Meanwhile, the use of ICER’s value framework to inform commercial payer decision makers is increasing. Are value- and outcomes-based strategies more important?
