Pricing & Reimbursement

When the first non-alcoholic steatohepatitis drugs reach market, the health cost watchdog says payers will be justified in setting step-therapy including weight-management efforts, while early prescribing should be by specialists.

China’s Basic Medical Insurance Fund spent 7.1 times more on novel drugs in 2022 compared to 2019, according to figures disclosed by the National Healthcare Security Administration. Meanwhile, such drugs need to wait less to be eligible for reimbursement in China.

The US Centers for Medicare & Medicaid Services’ Vinod Mitta discussed the agency’s latest thinking on the implementation of Medicare drug price negotiations at the Financial Times Pharma Summit.

The difficulty of finding and retaining patients with orphan diseases translates into higher marketing costs and adds to other restrictions that limit the attractiveness of some orphan drugs. Will the IRA exacerbate matters?

US FDA approval in Crohn’s disease further boosts the revenue potential for Rinvoq as AbbVie navigates a period of declining sales overall due to the introduction of US biosimilars for Humira. 

The US Federal Trade Commission is taking a stand against rebating and bundling practices pharma companies use in negotiations with payers as it seeks to block Amgen’s $28bn acquisition of Horizon.

Leonard Schleifer said it is time for US regulators to review whether certain rebate practices are anti-competitive, while speaking at the Financial Times US Pharma & Biotech Summit.

R&D heads of Takeda, Amgen, Lilly and Novartis discuss some of the tectonic forces shaping the biopharma sector and the unintended consequences of the IRA on small molecule innovation. Advances in the neurodegenerative diseases segment amid impressive data from donanemab was another key talking point.

The second week of first-quarter earnings featured AbbVie’s announcement and a harsh stock price reaction. There were also far-reaching implications behind the results.

The cost-effectiveness group voted by a slight margin that Madrigal’s non-alcoholic steatohepatitis drug offers benefit above lifestyle changes alone, but decisively that Intercept’s candidate does not.

BioMarin has yet to treat a patient with Roctavian, the first ever hemophilia A gene therapy, eight months after its first approval in Europe, as pricing delays cloud its commercial prospects.

The entire pharmaceutical industry will transform itself with digital technology while still facing the challenge of financial balance as a part of the healthcare ecosystem, says Takeda's CEO, who shared his views on the firm’s and wider industry's shifting business and R&D strategies at the recent CPHI Japan meeting.