Check out our latest news and articles.

Visit our Blog

New report tracks U.S. pivot from prescriber to payer

For several years we’ve noted the rising importance of payers and a marked shift in focus away from prescribers.

In a new report*, industry analysts detail further entrenchment of this trend in North America, as new pharmaceutical products and medical devices receive heightened attention in respect of their cost-saving attributes.

Cost constraints are particularly severe in Canada’s single-payer system, but healthcare budgets are under pressure in the U.S. too. The diversification of public sector payers here, including dispensers and third-party administrators, complicates the market access environment further.

The report’s authors stress the importance of mapping out a product launch sequence that focuses on front-loading countries that have positive pricing and reimbursement conditions, as well as strong demand.

While cost containment continues to inform the decision-making of payers and healthcare providers in the U.S.’ $374 billion prescription drug market, more attention is being paid to high-cost drugs targeted at unmet need. Healthcare industry analyst Adam Dion notes that:

The rise in premium-priced drugs has been most notable in the oncology and infectious diseases segments, particularly Amgen’s leukemia drug Blincyto, and Gilead’s hepatitis C virus treatments Sovaldi and Harvoni.

Despite discounts provided by manufacturers, the demand for innovative drug treatments in areas with high unmet need means that the continued influx of such therapies is likely to impact costs heavily for both insurers and patients.

Download Roche market access case study