It’s been a busy conference season for the market access space. Following on the heels of AMCP
in April,
Asembia
2024 brought together industry leaders and healthcare innovators for a dynamic exchange of ideas and strategies from April 28 to May 2 in Las Vegas.
Luckily, what happened in Las Vegas came home to Klick with topics reportedly ranging from the transformative impact of AI and digital health technologies to the nitty-gritty potential impact of the Medicare Inflation Reduction Act (IRA), highlighting the evolving landscape of value-based care, the burgeoning role of specialty pharmacies, and the pressing need for health equity.?
The conference buzzed with discussions on cutting-edge trends in market access and trade/distribution. Klick’s Value Access Reimbursement (VAR) team was there taking note of the top market access trends:
Top Five Trends in Managed Care at Asembia 2024
1. Value-Based Care and Population Health
- Highlight: A focus on general value-based care (VBC) strategies and population health management continues as VBC achievements remain elusive and challenging.
- VAR Analysis: AMCP and Asembia had predictable overlap. At the forefront of discussions at Asembia were the topics of innovative payment models and contracts, with a hopeful shift towards more holistic care for complex patient journeys. This time, though, the topic centered on rare diseases, cell/gene therapy, and oncology. In these spaces, more innovative pricing models and closer partnerships with specialty pharmacies (SPs) have emerged, though there is still a great need for improvement and reliable metrics to determine the impact on patient care. As has been the case, challenges with outcomes-based healthcare delivery, cost reduction, and improving patient outcomes through coordinated care practices continue to rise.
2. Inflation Reduction Act (IRA): Medicare and Payer Reactions
- Highlight: Discussions and predictions concerning IRA legislation continue to predict legislative ramifications, including payer strategy adjustment. Significant attention was also paid to the IRA’s implications for formulary design, drug-pricing negotiations, and the overall strategy adjustments required by health plans and PBMs.
- VAR Analysis: Payers are likely to continue to urge narrower formularies and out-of-pocket (OOP) smoothing. (OOP smoothing evenly spreads healthcare expenses over time for Medicare beneficiaries, aiming to alleviate the financial burden associated with high OOP costs.) As we have seen in the past, these same strategies will likely spill over to the commercial book of business.
- AI Keywords Count Tallied from Abstract and Presentations: IRA (9 times), Medicare (7 times), Payer Reaction (5 times)
3. AI and Digital-Health Technologies
- Highlight: Asembia sessions highlighted the use of AI, machine learning, and digital tools to enhance patient-journey analysis, adherence strategies, and overall healthcare service effectiveness and efficiency.
- VAR Analysis: AI’s growing practical applications are not just buzzwords. While technology solutions particularly focused on patient support and commercial analytics integrate AI features into our workflows, manufacturers and SPs are taking cautious steps to ensure AI is used responsibly and ethically. The main goal will be to offer measurable and impactful benefits to patients. However, data-driven decisions and strategies are being implemented across the board to optimize distribution and gross-to-net objectives on the manufacturer side, reduce time spent on therapy for specialty pharmacies, and target interventions for patient-support programs. There are tools for clinical outcome-focused healthcare, including specific case studies or examples of AI-integrated healthcare, which should help provide more tangible insights.
- AI Keywords Count Tallied from Abstract and Presentations: AI (8 times), Digital Health (4 times), Machine Learning (3 times)
4. The Growing Role of SPs
- Highlight: Discussions reflected the continued evolving role of SPs, the integration of biosimilars into treatment regimens, and strategies for market access and patient services in specialty care.
- VAR Analysis: Critical SP developments are increasing the adoption of restrictive management tactics while expanding patient eligibility. SPs are investing in technology and ancillary services to go beyond distribution to win manufacturer contracts. Investments include vertically integrating such advanced capabilities as reimbursement services and adherence. Several new technologies from third-party pharmacies were on display at the Asembia Expo, including workflow solutions that aim to streamline patient enrollment, optimize interventions, and enable specialty pharmacies to quickly automate both access and financial assistance to reduce time to dispense. The question remains: how soon before SPs become full-service distributors for manufacturers?
- AI Keywords Count Tallied from Abstract and Presentations:? Specialty Pharmacy (12 times), Biosimilars (6 times)
5. Health Equity and Patient-Centered Care
- Highlight: There was a clear focus on addressing disparities in healthcare access and outcomes, with an emphasis on designing inclusive and patient-focused healthcare practices to elevate outcomes for overall population health and well-being.
- VAR Analysis: Given the complexity of navigating health coverage, particularly in the context of Medicare changes, there’s a need to detail how these practices impact diverse populations, especially the elderly and those with rare diseases. What we know about health disparities is that the negative impact goes far beyond just the individual patient and extends to children, communities, and the healthcare system. Disparities limit overall gains for the broader population and the entire system.
- AI Keywords Count Tallied from Abstract and Presentations: Health Equity (5 times), Patient-Centered Care (7 times)
- Real-World Evidence (RWE) and Health Outcomes Research (HEOR) were discussed in the context of drug efficacy and safety, particularly in sessions about biosimilars and chronic-disease management.
- Commercialization and Market Access were also prominent, and they often intersected with discussions on specialty pharmacies and payer strategies.
These trends reflect the major discussion points and focus areas of the Asembia 2024 conference, providing a snapshot of current priorities and concerns in managed care and pharmaceutical strategy.
