Experts have called for major reform to the existing prior authorization processes with suggestions such as: Streamlining of administrative steps Tighter turnaround times for prescription authorization Widespread automation and digitization of processes Integration of health and administrative systems Nationwide coverage The lack of standardization among current approval processes are resulting in treatment delays, poor patient and physician experiences, low adherence rates, script abandonment, and in many cases, increased healthcare spending as disease progression worsens. Below are some examples that illustrate the burden of prior authorizations within specific therapeutic areas. Cardiology The cardiovascular treatment landscape significantly expanded in 2015 with a new game-changing class of drugs, PCSK9 inhibitors, which are intended to manage cholesterol-related cardiovascular disease
One of the most important considerations for any pharmaceutical manufacturer is determining the internal capabilities and capital needed to support drug commercialization. The reality is that small- and medium-sized life sciences companies lack the resources to match the commercialization strategies of big pharma. Fortunately, today, there are opportunities for small pharmaceutical companies to execute a go-to-market strategy through outsourcing
Drug formularies are a driving force for patient access to prescribed medication. A pharmaceutical brand’s inclusion and positioning on drug formularies are often reflective of the market access strategy’s level of success. To remain competitive, pharma manufacturers must understand how formulary management and the influence of payers are evolving and take steps to optimize market access
According to the National Diabetes Statistics Report from the CDC, around 37.3 million people have diabetes in the US, while 96 million have prediabetes. Type 2 diabetes remains the most prevalent in the US (90-95% of diagnosis), while both subtypes represent chronic illnesses that require rigorous self management of therapies for effective disease control. The increased prevalence of diabetes over the last 20 years unleashed a multibillion dollar pharmaceutical market that has pushed drug developers to aggressively pursue life-saving treatments for both type 1 and type 2 diabetes
The traditional route to pharmaceutical market access focuses on successful clinical trials and meeting regulators' safety and efficacy data requirements. In the past, this same data was sufficient for payers to determine that the drug was worth covering at the price point set by the manufacturer. But times have changed
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