Value of Health Series: MassBio’s Roadmap to the Changing Value, Access, & Reimbursement Landscape

We’re at an inflection point, with science that’s been tested for decades finally becoming a reality for patients and a payer system that has not caught up with this level of innovation. Myriad factors are combining to alter the status quo – with policymakers demanding action, and healthcare stakeholders agreeing that we must come up with real solutions to. If we don’t come together and address the value equation as an industry and ensure patient access to all new therapies, government or other stakeholders will – and they will likely get it wrong. 

This is the impetus behind MassBio’s Value of Health series, a major initiative to explore the future of the biotech industry through the prism of drug pricing. Guided by experts, we produced a series of three whitepapers and related events in 2019 that together sought to answer the question: is the current biotech pricing model sustainable, and if not, what needs to change?

Don’t miss your opportunity to be a part of this conversation. Download our whitepapers to learn about the changing access & reimbursement landscape early to mid-stage biopharma companies are in, and what actions they should take to ensure patient access. 

Part I: Defining Value 

Part I of the series explores the value equation from the perspectives of the various healthcare stakeholders, drawing from insights from a MassBio advisory group. Its goal is to educate biopharma companies, especially those in early and mid-stages, about the current and expected environment they’re operating in, and considerations these companies must make to ensure patient access when their drug comes to market. It is our belief that the sooner companies start thinking about value and how they will demonstrate it, the fewer hurdles to patient access will exist.

Download Part I here.

Part II: Public Payers in the U.S. & Key International Markets 

Part II of the series explores Medicare and Medicaid in the U.S., existing access and reimbursement issues for innovative therapies and cures, proposed changes to those programs that could impact access and reimbursement, and barriers that exist to innovative payment models. The paper also considers those key international models of assessing value and determining access, how the global landscape is shifting, what the U.S. may be able to learn from them, and highlight emerging markets like China that are moving toward the realm of “must consider” when developing an international strategy.

Download Part II here.

Part III: Potential Disruptors’ Impact on the System

The healthcare system is evolving as new players enter the arena and others consolidate. What impact will mergers between payers and PBMs have on drug pricing, patient access, and the ability to track and analyze data? How are digital technologies changing the way we track patients and ensure access? What impact will one-time cures have on the system? What new financing methodologies are gaining traction and what else can we do to support their widespread adoption? What new players are disrupting the value equation? Part III attempts to answer these questions and here.

Download Part III here.