D. Han; D.S. Mytelka; G.L. Warren; M. Ciarametaro; M. Trusheim. PharmaExec.com, 2018 After decades of anticipation, 2017 saw the approval of the first of a new generation of durable and … Read More
Designing financial solutions to ensure affordable access to cures
The reimbursement of emerging durable/potentially curative cell and gene therapies is likely to be a challenge for the US healthcare market. Considering the pricing of cell- and gene-based therapies approved … Read More
Stop-Loss Insurance or Reinsurance for Multiyear Contracts
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
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)
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
Impact of Actuarial Risk on Health Plans
The uncertain number of patients likely to be treated with an expensive novel therapy (actuarial risk) could represent a major financial issue for some payers. In this brief, we will … Read More
Designing Precision Financing for Cures
Designing Precision Financing for cures can be informed by a framework that tailors solutions to the three financing challenges of actuarial risk, performance risk and payment timing based on the … Read More
Payers Open to Innovative Financing Mechanisms for High Cost Gene Therapies
In a broad survey, payers favor performance based milestone contracts and risk pools strategies to absorb the surge of high cost gene therapy products expected to enter the market over … Read More
Pharmaceuticals Licensing and Reimbursement in the European Union, United States, and Japan
Clinical Pharmacology & Therapeutics, December 1, 2016A. Oye, H. G. Eichler, A. Hoos, Y. Mori, T. M. Mullin, and M. Pearson This article describes recent developments in licensing and reimbursement … Read More