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
Antiviral drug approvals over the last decade have been dominated by drugs aimed at treating Hepatitis C (HCV) and human immunodeficiency virus (HIV). An estimated 2.4 million to 4.7 million people are living with HCV in the US, while about 1.2 million people in the US live with HIV. While these are both huge markets that continue to attract big pharma development efforts, the competitive landscape has become multi-layered and complex with long-standing therapies being evaluated alongside newly approved combinations
Specialty drugs comprise a growing share of the pharmaceutical market. According to an industry report by Drug Channels, total prescription revenues surpassed $500 billion in 2021, with specialty drugs accounting for almost 40 percent of outpatient prescription revenues and an even larger share of payers’ net prescription costs. Over the next five years, these therapies are projected to account for at least half of all revenue generated by the pharmacy industry
There was a time when the path from a physician prescribing to the patient starting drug therapy was straightforward. With the rise of value-based healthcare and novel specialty treatments, that’s no longer the case. Today, rigorous payer requirements and increasing out-of-pocket obligations frequently hinder patient access
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Our consultants will work with you to analyze your current channel strategy and make recommendations for how to improve patient access and increase the percentage of scripts getting covered by insurance.