-
Americas
-
Asia & Oceania
-
A-I
J-Z
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more -
Middle East & Africa
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
Regions
-
Americas
-
Asia & Oceania
-
Europe
-
Middle East & Africa
-
Americas
-
Asia & Oceania
-
Europe
Europe
- Adriatic
- Belgium
- Bulgaria
- Czech Republic
- Deutschland
- España
- France
- Greece
- Hungary
- Ireland
- Israel
- Italia
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more -
Middle East & Africa
EMEA Thought Leadership
Developing IQVIA’s positions on key trends in the pharma and life sciences industries, with a focus on EMEA.
Learn more
WHO WE HELP
-
Pharmaceutical Manufacturers
-
Emerging Biopharma
-
MedTech
-
Financial Institutions
-
Government and Public Health
-
Health Plans
-
Hospital and Health Systems
-
Insurers and Risk
-
Medical Specialty and Patient Advocacy
Pharmaceutical Manufacturers
Harness unparalleled healthcare data, advanced analytics, and cutting-edge technologies with our expertise to accelerate the development and commercialization of innovative medicines, enhancing patient lives.
Discover MorePharmaceutical Manufacturers
Emerging Biopharma (Global page)
Boost your innovation with IQVIA's expert team. Our comprehensive solutions integrate top-tier insights, technology, and expertise to maximize your asset's success in a competitive landscape.
Discover InnovationsMedTech
Navigating MedTech's unique landscape: U.S. decision-making now rests with GPOs, IDNs, and payers, who demand solid value proof through rigorous outcomes analyses and pricing scrutiny.
Explore MedTechMedTech
Financial Institutions
Invest in healthcare with confidence. Stay ahead of pharma and medical device trends using real-time, high-quality data. Access market insights, historical sales, prescription trends, and emerging product information for informed, risk-reduced decisions.
Access InsightsGovernment and Public Health
Unlock deeper health insights with unmatched data and innovative technology to enhance decision-making for your essential government programs.
Unlock InnovationsGovernment and Public Health
Health Plans
Accelerate digital innovation with our data-driven expertise in data science and healthcare, optimizing business processes for smarter decisions.
Navigate Health PlansHospital and Health Systems
Leverage digital innovation to cut costs, boost efficiency, and elevate patient engagement, all while enhancing quality and health outcomes.
Streamline DecisionsHospital and Health Systems
Insurers and Risk
Enhance your ability to evaluate and forecast population risk swiftly and accurately by integrating unmatched data, expertise, and technology.
Uncover More
Medical Specialty and Patient Advocacy
Transform into a data-driven organization that enhances your specialty and showcases value to your members through digital transformation.
Explore NowU.S. PROGRESS POINT
A curation of IQVIA's best thinking on topics and trends driving change, disruption, and progress in the United States healthcare market.
LEARN MOREBLOGS, WHITE PAPERS & CASE STUDIES
Explore our library of insights, thought leadership, and the latest topics & trends in healthcare.
DISCOVER INSIGHTS
PODCASTS
"Discover the future through our enlightening podcasts available in the United States.
EXPLORE PODCASTS
Blog
Trends to Watch through 2023: Pharmaceutical benefit managers' rising purchasing power
Mar 21, 2022
As we launch into 2022, it’s time for our stakeholders to look ahead and begin making and adjusting their yearly goals. It will be important to explore what trends in pharma are developing and how they may impact those working in the industry. In this blog series, we will explore the top seven trends we see emerging in 2022 and 2023, and how our customers should respond.
We at IQVIA expect to see an increased importance in the role that pharmaceutical benefit managers (PBMs) play in 2022 and beyond. This blog explores their rising power and the influence they carry.
Pharmaceutical benefit managers’ rising purchasing power
Programs such as Copay Accumulator Adjusters and 340B do not exist in a vacuum; they are dynamics in a larger market access ecosystem that should be considered alongside rebates, copay cards, and other forms of patient assistance programs.
Simultaneously with these market events, payers are increasingly encompassing the prescription value chain to gain control and reduce transaction costs while finding new ways to generate margin. PBMs are now influencing the value chain by going beyond traditional access rebates. As more prescriptions are pushed into vertically integrated specialty pharmacies, the large integrated entities are able to exert more control on utilization. The vertical integration further inflates brand exposure to Accumulator Adjuster and Copay Maximizer programs while increasing the PBMs’ ability to further lower their costs by taking full value of manufacturer-sponsored programs.
As control and strength increase, so too, does leverage which manifests itself in higher rebates and pharmacy fees. Most recently, the large PBMs have been seen to move even further into the value chain by creating their own group purchasing organizations (GPOs). These GPOs now allow for the PBM to shift discounts into complex fee structures that are less transparent. The larger and more complex the organization, the easier it is to exert pressure and value through consolidation strategies.
The growing purchasing power and control by payers is a challenge not only for manufacturers, but also challenges patient access. Over the past decade, as payer consolidation and control has increased, patients treated with specialty medications are feeling the pain. Patients treated with specialty therapy are 20% less likely to fill a specialty medication prescription than they were in 2013 (figure 1).
At the same time, the number of prescription products facing an NDC block has grown to include over 450 at the large PBMs, directly impacting the number of products available to patients. These NDC blocks, also known as formulary exclusions, are powerful controls and drive manufacturer access rebates higher as more classes become exposed.
Figure 1
In our next blog, we will explore a new era for value-based pricing agreements.
Top Issues for Pharma to Watch in 2022 and 2023
Coming out of the global COVID-19 pandemic, the future holds both opportunity and increased complexity for the pharmaceutical industry. There are many important issues for pharma to watch in the near future as economic factors will continue to put pressure on revenue and margins. Seven important issues for pharma to watch in 2022 and 2023 that focus on policy, payer, and patients are explored during this webinar.