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CMS Hospital Pricing Transparency: One Price Fits All?

August 02, 2021 Executive Summary: A CMS regulation from the Trump Administration requiring hospitals to post lists containing the list price, negotiated private payer prices, and self-pay rates for up to 300 shoppable services took effect in January 2021 but is still widely ignored by hospitalsA lack of enforcement coupled with minor penalties decreases the efficacy of the requirement, resulting in low incentive for hospitals to comply with the ruleThe data posted by compliant hospitals shows large variation in pricing…

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Is the Pricing Discount for Chinese NRDL Inclusion Worth it? NRDL Commercial Impact Assessment

July 06, 2021 Executive Summary The Chinese National Reimbursement Drug List (NRDL) is managed and negotiated by the National Healthcare Security Administration (NHSA) and drugs listed on the NRDL are reimbursed by the public insurance Since 2017, on average, a significant price discount of 44-61% was required for products to achieve a positive listing on the NRDL Based on average 2018 sales data, products included on the 2017 NRDL were able to achieve an increase in sales revenue (188%) despite…

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Poland’s Medical Fund Bill to Improve Access to Oncology Drugs

June 02, 2021 Executive Summary The Medical Fund Bill would increase drug spending up to 4% of the total healthcare spending in PolandThe reimbursement applications can be reviewed as quickly as 180 days, reducing the typical time-to-market of two – three yearsThe criteria for “innovativeness” that need to be met for inclusion on the list are still not fully fleshed out to dateOnly four of the 12 candidates on the list have been approved by the Health Minister to secure reimbursement…

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Novel Combinations: Double the Trouble

May 25, 2021 Executive Summary Branded novel combinations are increasingly entering the oncology market but bring a unique set of challenges to gain access and pricing successDynamics beyond demonstrating synergistic efficacy should be taken into consideration to optimize combination price / access outcomes Trinity’s Take: In this article, Trinity uses select combination case studies to highlight the key elements to consider when thinking through price / access strategy for a novel combination Evaluation of the Novel Combinations Landscape The pursuit of…

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The Future of Cell Therapy: What’s Next?

November 03, 2020 Executive Summary Cell-based therapies are emerging as a promising strategy for cancer and are generating a lot of interest both academically and industriallyTo date, cell therapies have been approved in the US by the Food and Drug Administration (FDA) with them showing a lot of promise in a limited number of solid tumors although they have not yet progressed to FDA approvalThere have been multiple challenges involved when trying to successfully commercialize the products, but the landscape…

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CAR Ts: Barriers and Opportunities for the Migration into Earlier Lines of Therapy in the USA

September 22, 2020 Executive Summary Although CAR Ts are on the cutting edge of oncology treatment, they are still only approved for administration following at least two other lines of treatmentKey barriers for CAR T migration into earlier lines include the complex logistics and site of care restrictions, a lack of comparative 3L+ and 2L clinical trial data, and reimbursement uncertainty in fee-for-service (FFS) MedicareNew opportunities to overcome these hurdles are being pursued in the form of innovative pricing and…

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