Massachusetts Pilot Disease Selection

Eric NormanLEAPS, Research Briefs

Rheumatoid Arthritis (RA) chosen as target for LEAPS Massachusetts (MA) Pilot (RAMA) to demonstrate the feasibility and impact of a sustainable and patient-centered healthcare learning ecosystem to optimize care regimens … Read More

Pediatric Gene Therapy Launches

Eric NormanFoCUS, Research Briefs

Gene therapy cures for hereditary genetic conditions are likely to reach the United States market in the coming decades. Several disease areas with potential cures are orphan conditions, which affect … Read More

Patient & Caregiver Themes Survey

Eric NormanFoCUS, Research Briefs

Patients and caregivers are key stakeholders in the development of system-wide, implementable precision financing models for durable and curative therapies. Patient and caregiver challenges are generally assumed to be primarily … Read More

Incorporation of Value-Based Payment Agreements into the Calculation of Medicaid Drug Rebates

Eric NormanFoCUS, Research Briefs

Value-Based Payment (VBP) agreements will play an important role in mitigating uncertainty in durable therapies, where it is unclear whether a large upfront payment is justified based on limited clinical … Read More

Clinical trials and investment trends for novel CAR-T and TCR therapies

Eric NormanFoCUS, Research Briefs

Compared to small-molecule therapies, the nature of CAR-T/TCR therapies is such that they can be diversified with lower probability of failure in the clinic. Many companies and academic entities are … Read More

Model Contracts for Innovative Oncology Therapies

Eric NormanFoCUS, Research Briefs

When there is substantial uncertainty about a new product’s expected value, stakeholders may have strong reasons to consider performance-based contracts. One of the hardest tasks in crafting such contracts is … Read More

Role of COE networks in curative cellular oncology therapies

Eric NormanFoCUS, Research Briefs

COE networks currently play an important role in the delivery of care for specialized service lines, including but not limited to solid organ transplantation (SOT), hematopoietic cell transplantation (HCT) and … Read More

Stop-Loss Insurance or Reinsurance for Multiyear Contracts

Eric NormanFoCUS, Research Briefs

In previous Research Briefs, we have discussed challenges faced by payers when contemplating using multiyear performance-based contracts. In this brief, we extend the discussion to include additional difficulties that may … Read More

Impact of Patient Mobility on Annuity/Performance-Based Contracting

Eric NormanFoCUS, Research Briefs

Spreading payments over time for durable or curative therapies can provide a better alignment between benefits and costs, but creates challenges when patients switch insurance coverage during the contract term. … Read More

Orphan Reinsurer Benefit Managers (ORBMs)

Eric NormanFoCUS, Research Briefs

An Orphan Reinsurer Benefit Manager (ORBM) could address the financial challenges (payment timing, therapeutic performance risk, actuarial risk), created by durable/potentially curable gene and cell therapies especially for smaller insurers … Read More