How can self-insured employers prepare for the portfolio impact of highcost gene therapies coming to market?

Eric NormanFoCUS, Research Briefs

Self-insured employers (SIEs) currently rely on traditional stop-loss insurance to protect against unexpected high-cost claims, including those for cell and gene therapies. Given that current approvals are in rare diseases, … Read More

The resource navigation challenges for patients and caregivers

Eric NormanFoCUS, Research Briefs

Share the researchWhile the problem of finding system-wide, implementable precision financing models for curative and durable therapies involves all stakeholders, patients and caregivers are directly affected by many different elements … Read More

Impact of FDA Guidelines on Communication between Developers and Payers on Metrics in Performance-Based Agreements

Eric NormanFoCUS, Research Briefs

The FDA regulates communications from pharmaceutical developers to ensure that statements about products are appropriately supported by evidence. In this Research Brief, we explore the possible impacts of these regulations … Read More

Precision Financing challenges for solid tumor adoptive T-cell therapies

Eric NormanFoCUS, Research Briefs

Durable gene and cell therapies represent a unique challenge to the US healthcare insurer/payer landscape, given the one-time treatment and associated high upfront cost but potentially durable outcomes. Previous research … Read More

The Role of Stop-Loss Insurance and Reinsurance in Managing Performance-Based Agreements

Eric NormanFoCUS, Whitepapers

Over the last decade, rising healthcare costs and the availability of expensive new treatment options has led to a substantial increase in the number of patients with large insurance claims. … Read More

Payer Perspectives Survey

Eric NormanFoCUS, Research Briefs

A survey of 77 payers representing over 280 million lives, completed in April 2019, explored perspectives concerning financing challenges and management strategies associated with durable cell and gene therapies. Download … 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

Precision Financing Solutions for Durable / Potentially Curative Therapies

Eric NormanFoCUS, Whitepapers

The NEWDIGS FoCUS consortium of multiple stakeholders (payers, providers, patient advocacy organizations, pharmaceutical developers, academics and others) has been working collaboratively since 2016 to address the need for new, innovative … 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

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