Payer Insights on Industry Trends

Xcenda gathers strategic insights from Managed Care Network (MCN), a nationally representative group of payer decision makers who make product coverage decisions for nearly 200 million covered lives. Select a topic below to learn what MCN members told us about our industry's latest trends.  

• Utilization trends for manufacturer contracts and coinsurance
• Utilization management within oncology
• Utilization of comparative effectiveness research
• How healthcare reform is impacting managed care's business operations 
• How pharma is using health outcomes and pharmacoeconomic data to support product value propositions

Need payer insights about your product? Join us for the September MCN live meeting.

From testing value messages to assessing contracting strategy and demonstrating models or field tools, the MCN meeting is an efficient and compliant way to collaborate with payers.

What You Need to Know about Compendia

According to the National Comprehensive Cancer Network (NCCN), 50% to 70% of all uses of cancer drugs are off-label¹. A positive or a negative listing in one or more of the Medicare-approved drug compendia can have a significant impact on whether a pharmaceutical product is covered, ultimately affecting prescribing decisions and patient access.

As such, Xcenda recommends five key tasks to help manufacturers consider the impact of the compendia on their pipeline and current brands.

Multiple Myeloma Update – A Key Finding from ASCO 2010

Initial chemotherapy (CT) followed by consolidation with high-dose CT and autologous stem cell transplant (ASCT) is a standard, first-line strategy for “fit” patients with multiple myeloma (MM). The availability of new agents (eg, bortezomib, lenalidomide) used in doublet and triplet combinations appears to enhance cytoreduction (increased complete response and overall response rates) achieved with initial CT. Current guidelines from professional organizations and academic leaders in the myeloma field continue to recommend ASCT as part of first-line therapy in appropriate patients.

We studied whether the magnitude of response achieved with the initial CT regimen impacts plans of more than 325 American hematology-oncology physicians (AHOMD) to recommend ASCT consolidation as part of overall first-line therapy¹.  View findings…

Healthcare Reform Update - CMS Issues Proposed CY 2011 Hospital Outpatient Rule

Late in the day on July 2, 2010, the Centers for Medicare and Medicaid Services (CMS) released its proposed Calendar Year (CY) 2011 Hospital Outpatient Prospective Payment System (OPPS) rule. The same rule also addresses the revised Ambulatory Surgical Center (ASC) payment system and implements key provisions of the Patient Protection and Affordable Care Act of 2010 (ACA).

This update is focused on the hospital outpatient setting and offers a preliminary, high-level overview of the proposed rule provisions affecting manufacturers and providers, particularly those relating to reimbursement for drugs and biologicals. If you are interested in a customized analysis, please do not hesitate to contact us.