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Latest From Anthem Inc.

Elevidys’ Restricted Label Helps Sarepta Pressure Payers For Coverage Of DMD Gene Therapy

Sarepta says the age limit in the indication could encourage swifter insurance coverage of the newly approved gene therapy for Duchenne muscular dystrophy so potential patients don't age out of the treatment window before they would be eligible for reimbursement.

Reimbursement Approvals

ICER Will Explore Link Between Reasonable Drug Pricing And ‘Fair’ US Formulary Policies

Study will examine prior authorization and other access restrictions at 15 of the largest US commercial payers for a group of 27 drugs.

Commercial Market Access

ICER Study On Coverage 'Fairness' Could Inform Manufacturer Pricing vs Benefit Design Debate

Study will look at prior authorization, step therapy and required medication switching for drugs considered to be reasonably priced.

Reimbursement Pricing Debate

Express Scripts Could Negotiate Drug Rebates For 100m Lives With Prime Therapeutics Deal

Manufacturers will face the “biggest PBM ever” in price negotiations for pharmacy benefit drugs as a result of the collaboration between the two pharmacy benefit managers.

Reimbursement Pricing Strategies
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