Health plans conduct individual risk assessments: Broadly speaking, smaller beneficiary numbers result in higher financial exposure on a perpatient cost basis and comparatively greater operational challenges given the need for highly specialized treatment knowledge. Some small commercial payers, self-insured employers, MA Advantage and Medicaid can be expected to see a higher impact than larger commercial payers and Medicare Fee-for-Service. Insurance risks vary further across therapy modalities for the different target populations in question. Payers think that multiple payment solutions are required to mitigate the impact of a proliferation in transformative high-cost therapies – but few concrete mechanisms exist today.
At Certara, we accelerate medicines to patients, partnering with life science innovators. Together with our partners, we use biosimulation and technology-enabled services to transform drug discovery and development. For more information visit www.certara.com or email sales@certara.com.