Our Company

This paper describes how the proposed rule to eliminate the long-standing safe harbor protection for prescription drug rebates paid to Medicare Part D sponsors and pharmacy benefit managers may affect the Medicare Part D market.

Claims-based predictive modeling may help identify patients at risk for multiple sclerosis and assess disease burden.

This study develops a machine learning model that identifies patients in a commercial medical claims database who likely have exocrine pancreatic insufficiency but are underdiagnosed.

This report examines why Medicare Part D plans that share manufacturer rebates at the point of sale under a voluntary system will likely have a rather high premium relative to market averages.

The Centers for Medicare and Medicaid Services released its proposed 2020 risk score methodology for Medicare Advantage plans in December, and it describes proposed updates to the existing Hierarchical Condition Category (HCC) risk adjustment model and suggests an alternative model, which includes two HCCs for dementia.

This report identifies several disconnects between the Institute for Clinical and Economic Review’s work and its potential use by private payers to analyze the impact of new drugs on their budgets.

For colorectal cancer screening, does computed tomography have a cost advantage relative to optical colonoscopy for the commercially insured U.S. population?

There are some valuable lessons for pharmaceutical manufacturers in provider alternative payment models (APMs), but whether pharmaceutical APMs succeed or fail will depend on finding solutions to operational and logistical challenges—some of which are unique to the pharmaceutical industry.

This report identifies several disconnects between the Institute for Clinical and Economic Review’s (ICER) work and its potential use by private payers, which could help explain why private payers make little use of ICER assessments when making coverage decisions.

The dynamics of alternative payment models suggest a potential win for insurers, pharmaceutical manufacturers, and patients through an emphasis on reducing cost and improving outcomes.