A common challenge for specialty and specialty-lite brand commercialization teams is maximizing prescription coverage while minimizing free goods program overutilization. Patient bridge and quickstart programs, which provide temporary access to medications for patients experiencing coverage gaps or delays, are essential for therapy continuity and preventing financial burden on patients. However, these programs can negatively impact the manufacturers’ bottom line if manufacturers don’t implement the appropriate safeguards and requirements

Launching a New Drug in a Category with Generic Alternatives

Getting an innovative prescription drug approved for patient use is a significant milestone – however, it's only the beginning and certainly does not ensure the brand's commercial success. Considering it typically takes ten years and over $2.6 billion for a life sciences manufacturer to move a drug from its initial discovery into the marketplace, commercialization teams must employ effective launch strategies that differentiate their brand to get it into the hands of patients. Launching into a category with generic alternatives presents a unique challenge because payers often limit patients' access to the new entrant through utilization management tools that favor the lower-cost generics

What Makes Phil’s Prior Authorization Process Unique?

The prior authorization process (PA) presents a significant (and growing) roadblock for healthcare providers trying to get a patient started on a prescription therapy they deem best. In general, a PA requirement affects patients' experience with their healthcare. It represents a length of time – and the associated frustration – they must wait to receive their medication or go without the treatment they have been introduced to by their provider and may desperately need

Transforming the Prior Authorization Process: How Feedback Loops can Improve Patient Access to Life Sciences Brands

The use of prior authorization (PA) to control the utilization of prescription drugs, especially specialty medications, is growing, with 79% of medical practices reporting that PA requirements increased between 2021 and 2022. By design, the PA process is a barrier to medication access – it can leave patients waiting for days, weeks, or even months for approval, and coverage denial may occur despite a therapy being appropriately prescribed. The negative consequences of delaying treatment are well documented, yet more than 8 out of 10 patients still experience delays accessing their medications for reasons such as cost and insurance challenges

Prior Authorizations: What Pharmaceutical Manufacturers Need to Know

As healthcare costs have escalated over the last several decades, public and private medical insurers have introduced different utilization management (UM) strategies to control healthcare expenditures. The proliferation of higher-cost specialty medications has accelerated the use of drug UM tools to control access, with prior authorization (PA) being the most common today. From the payer's perspective, PAs are necessary to improve quality of care and protect patients’ safety