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The New Sales Model: Virtual Engagement in the Time of COVID-19 August 10th, 2020 The Centers for Medicare and Medicaid Services (CMS) issued a Proposed Rule on June 19, 2020, that, if implemented as written, would present challenges to pharmaceutical manufacturers that offer co-pay assistance programs. The Proposed Rule addresses the impact that PBM co-pay accumulator adjustment programs have on co-pay assistance programs and their exclusion from the best price determination. As written in 42 CFR § 447.505(c)(8) through (12) - Determination of best price, manufacturer-sponsored co-pay assistance programs, coupons, [...]

The New Sales Model: Virtual Engagement in the Time of COVID-19 August 10th, 2020 Earlier this week Rick Fry highlighted notable trends in co-pay accumulators thus far in 2020. As this issue continues, the natural question being asked by nearly everyone that has any involvement with the topic is “what’s next?” In this article, I’ll outline some specific areas of interest related to co-pay accumulators and maximizers heading into 2021. Clarity of New Rule Driving More Plans to Implement The 2020 Notice of Benefit and Payment Parameters caused uncertainty throughout [...]

The New Sales Model: Virtual Engagement in the Time of COVID-19 August 10th, 2020 Co-pay accumulators have become a fixture in the pharmaceutical patient support services landscape in recent years, as the ongoing tug-of-war between manufacturers and payers continues over who should bear the cost burden for specialty drugs. This week my colleague Jason Zemcik and I will be discussing the current state of co-pay accumulators. We will also examine recent market developments and share our expectations for the rest of this year and 2021. Today’s article will focus on [...]

The New Sales Model: Virtual Engagement in the Time of COVID-19 August 10th, 2020 As those in the clinical trial arena know, the supply chain department is often charged with the difficult task of preparing clinical sites for their first patients under a very aggressive timeline. This process involves drug sourcing, label creation, packaging, shipping, and more. Clinical supply personnel understands how vital it is to solve problems, track down essential medications and supplies, manage budgets, and maintain important partner relationships. These responsibilities, if ignored, could threaten the success of [...]

The New Sales Model: Virtual Engagement in the Time of COVID-19 August 10th, 2020 Last week, the Centers for Medicare and Medicaid Services (CMS) released the final 2021 Notice of Benefit and Payment Parameters (NBPP) rule. The complete rule is 350 pages and covers a variety of topics, including one that has been of particular interest to pharmaceutical manufacturers in recent years—co-pay accumulators. This post will provide a high-level overview of what the provisions in the 2021 NBPP mean for co-pay programs going forward. Plan sponsors can, but are not [...]