Truth & Consequences: Pricing, Patient Access and What’s Next for Today’s BioPharm

June 15, 2016

Today’s exciting medical innovations should be shining moments for biopharma. Instead, companies are increasingly being tarnished by a backlash over prices. Increased scrutiny means the old way of justifying a therapy’s price is obsolete. Influential stakeholders are demanding collaboration and transparency to maximize patient access.

A productive debate about pricing requires industry leaders, policy makers, clinicians, and even patients to have a better, more comprehensive, understanding of how the market landscape – including risks – have shifted in recent years. We’ve seen payment reforms such as bundled payments; limited global health care budgets; greater provider risk for outcomes; payer consolidation and new insurance designs that shift more costs to patients. And this is just the tip of the iceberg.

Traditionally, biopharma companies have addressed these risks by speaking to the value of innovations. Increasingly, however, that value analysis is not resonating with payers, providers, and even patients. They are shifting the discussion, changing the dialogue, and altering the debate. Rather than speaking of “the value of innovation,” these stakeholders are criticizing the price of treatments and concerned about affordability.

Unquestionably, affordability is a huge issue that must be addressed – but it is really step two. Step one is the need to get the value question right. It is clear that simply developing products to meet scientifically-defined “unmet medical need” is not sufficient in today’s markets.

Learning Objectives

Upon completion of the session, you will know how to:

  • Identify key issues affecting the treatment pricing and patient access landscape
  • Apply potential models for determining a treatment’s value
  • Integrate new ideas for communicating a product’s rationale for patients, treaters and payer

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