Pharma Pulse 5/14/24: The Impact of Medicare Advantage Employer Group Waiver Plans, The Need for Stepped-Up Patient Support & more


The latest news for pharma industry insiders.

Patient Treatment & Travel: The Need for Stepped-Up Support

Drug manufacturers have a long-standing history of providing hub support to help patients navigate the path to product access, effectively utilize their insurance coverage, and understand what other support may be available. But for certain types of therapies, more is needed.

The Impact of Medicare Advantage Employer Group Waiver Plans

The National Institute for Public Employee Health Care Policy released a new report sharing a deeper look at these plans and their value to the public sector.

Patient Dies Weeks After Kidney Transplant From Genetically Modified Pig

Richard Slayman received the historic procedure in March. The hospital said it had “no indication” his death was related to the transplant.

Topcon Healthcare Inc. (THI) Partners with Microsoft to Deliver AI-Powered ‘Healthcare from the Eye’ Through a Connected Healthcare Platform

Topcon Healthcare Inc. (THI) announces a partnership with Microsoft Corporation to deliver AI-powered ‘Healthcare from the Eye’ solutions to improve healthcare access, cost, and quality. A cloud-based connected network of healthcare providers using the Nuance Precision Imaging Network and the THI Harmony platform will empower patients and healthcare providers to participate in pre-screening for systemic and neurological disease via a robotic, rapid, and non-invasive eye scan.

Amy Niles on LinkedIn:

Last month, I wrote a piece for Pharmaceutical Commerce Magazine about step therapy (also known as "fail first"), a tool used by health plans to control spending on patients' medications.

With step therapy, an insurance company may require a patient to try different medications and treatments and have those "fail first'' before they're able to access the drug initially prescribed by their physician.

It's a way to contain the cost of prescription drugs, but it can notably result in delayed access and negative side effects.

A national poll from the PAN Foundation Center for Patient Research found that most adults (55%) who have been required to “fail first” say the policy delayed their access to the medication their healthcare provider (HCP) originally prescribed by up to 11 weeks.

- 1 in 6 (16%) adults say their HCP has required them to “fail first” before authorizing drugs prescribed by their HCP.

- The majority (59%) of adults who have been required to “fail first” say they appealed their health insurance provider’s request.

- 1 in 5 adults who were required to “fail first” say they had to visit the emergency room (21%) or be admitted to the hospital (20%) because of the policy.

Although most states have passed laws addressing the issues related to step therapy, there is no federal legislation—and it is direly needed.

Learn more about why Congress should pass the Safe Step Act:

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