How to ensure positive payer engagement for orphan drug market access
The explosion in orphan drug approvals and high prices are causing increasing concern to payers.
When there were few orphan drugs for small patient populations the cost was less of an issue. But with the orphan drug bill pushing 10% of drug spending to treat less than 1% of patients, hard questions are being asked and tough choices being made.
The current trends are unsustainable and payers are looking to rein in costs through vigorous HTA assessment, innovative contracting, and higher proof of value. Orphan drug developers need to take seriously the issues payers face and Orphan Drug Market Access: Payer Insights is a “must read” report that shows how positively working with them will have real market access benefits.
To ensure candid views were expressed, payer names have been kept anonymous, but each has been selected for their experience and detailed current knowledge of orphan drug issues.
“I don't think it's fair for the payer system to inherit an orphan-like drug price for a non-orphan disease.”
US Payer 1
“We cannot decide at the hospital level to choose between patients. If you have no money to pay for very expensive drugs, the government says, ‘okay, you have to manage the problems yourself.’ But we cannot manage the problems ourselves, because we have a lot of patients coming into the hospitals.”
French Payer
“I think a good model is having companies which can maybe arrange face to face interviews, advisory forums, payer forums where they have more in-depth, deep-dive discussions. I think there's a few companies doing that. Basically they need to do that more now.”
UK Payer
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How to ensure positive payer engagement for orphan drug market access
The explosion in orphan drug approvals and high prices are causing increasing concern to payers.
When there were few orphan drugs for small patient populations the cost was less of an issue. But with the orphan drug bill pushing 10% of drug spending to treat less than 1% of patients, hard questions are being asked and tough choices being made.
The current trends are unsustainable and payers are looking to rein in costs through vigorous HTA assessment, innovative contracting, and higher proof of value. Orphan drug developers need to take seriously the issues payers face and Orphan Drug Market Access: Payer Insights is a “must read” report that shows how positively working with them will have real market access benefits.
To ensure candid views were expressed, payer names have been kept anonymous, but each has been selected for their experience and detailed current knowledge of orphan drug issues.
“I don't think it's fair for the payer system to inherit an orphan-like drug price for a non-orphan disease.”
US Payer 1
“We cannot decide at the hospital level to choose between patients. If you have no money to pay for very expensive drugs, the government says, ‘okay, you have to manage the problems yourself.’ But we cannot manage the problems ourselves, because we have a lot of patients coming into the hospitals.”
French Payer
“I think a good model is having companies which can maybe arrange face to face interviews, advisory forums, payer forums where they have more in-depth, deep-dive discussions. I think there's a few companies doing that. Basically they need to do that more now.”
UK Payer
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