The US Payer Problem – and why it’s getting worse
The pharma world is on tenterhooks, waiting to see how the Inflation Reduction Act will impact drug innovation and pricing, and how the Federal Trade Commission could foil M&A plans. As valid as these concerns are, however, they shouldn't overshadow what is arguably a more pressing issue: the shifting dynamics in the US payer landscape.
The consolidation of insurers and pharmacy benefit managers has significantly increased their influence in drug supply negotiations, leading to a shift where the largest US insurer, UnitedHealth Group, now surpasses the valuation of almost all big pharma companies, a scenario previously unimaginable.
This raises pivotal questions: In the balancing act between payers and pharma companies, are payers now taking the lead? And how will this power shift impact the pharma industry and the availability of treatments for patients?