Rebate Efficiency

In the face of continually rising health care costs, and structural shifts towards cost containment accelerated by the passage of the Affordable Care Act (ACA), the U.S. health care industry has undergone rapid and remarkable change. Confronted with budget constraints, payers have abandoned their role as passive middlemen, and are instead consolidating, reorganizing, and exerting more control over burgeoning costs.

Employers and consumers are demanding lower cost health insurance options. Payers must be able to demonstrate that they can effectively limit medical inflation, despite new and more expensive advances in treatment, in order to remain competitive.  This in turn has driven payers to more explicitly and aggressively use a variety of methods to control costs.

Together, the convergence of these trends has placed new pressures on the pharmaceutical industry to secure favorable formulary coverage in order to maintain and grow share. However, lost in the discount-at-all-costs mentality driven by this traditional notion of market access is a focus on profitability.

In this white paper we examine why it has become critical for manufacturers to adopt a strategic, comprehensive, and institutionally aligned approach to address the changing power of the payer in access negotiations, in order to preserve demand and protect their margins.

The Declining Value of Payer Access: How to Improve Rebate Efficiency

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