Latest From Tim Casey
Looming Step Therapy Ban In Illinois Is ‘Game Changer,’ Could Start Trend
Federal legislation on PBM reforms has stalled, but state efforts remain active. Illinois’ Healthcare Protection Act includes several other limits on insurer power, including prohibiting prior authorization for inpatient mental health care.
Incorporating Pharmacy Spending In Value-Based Payment Models Remains Challenging
Various government and private payer initiatives are good steps forward, but lack coordination. Payers continue to face perverse incentives to use high-cost drugs because of rebates in 340B, while providers don’t have enough incentives to use cost-saving clinical decision tools.
Pear Bankruptcy Filing Highlights Difficult Challenges Facing Digital Therapeutics
Pear Therapeutics filed for Chapter 11 bankruptcy in April and sold its remaining assets in an auction for about $6m. The demise of one the pioneers in the prescription digital therapeutics industry highlights the challenges PDT developers face getting their products reimbursed.