Radar on Specialty Pharmacy

Gene Therapies, Other Innovative Agents Will Spur Evolving Payment Models

  • Jan 09
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    Jan 09, 2025

    As more and more innovative therapies launch in the U.S., payers will continue to explore a variety of tactics in their coverage of those drugs, including carveouts, outcomes-based arrangements and medical benefit management. And while the Inflation Reduction Act (IRA) is focused specifically on Medicare beneficiaries, the legislation — in particular its drug price negotiation provision — likely will impact commercial plans. These are only some of the specialty pharmacy issues to keep an eye on in 2025, according to industry experts who spoke with AIS Health, a division of MMIT, for our annual series of outlook stories on the year ahead. (Editor’s note: These comments have been edited for length and clarity.) 

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    • Angela Maas

    Angela has an extensive background of editing, reporting and writing for trade and consumer publications. She has written Radar on Specialty Pharmacy since she joined AIS Health in 2005 and has broad knowledge of the various issues at play within the space. She also has written for Spotlight on Market Access since its 2017 launch. Before joining AIS Health, she was managing editor at Employee Benefit News and Employee Benefit News Canada and managing editor at Hem Aware (a hemophilia publication), Lupus Living and Momentum (a multiple sclerosis publication). She has a B.A. in English and an M.A. in British literature from Arizona State University.

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Lauren Flynn Kelly

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Managing Editor, Radar on Specialty Pharmacy and Spotlight on Market Access

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Managing Editor, Health Plan Weekly and Radar on Drug Benefits

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Tim Casey

Reporter, Health Plan Weekly and Radar on Drug Benefits

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Reporter, Radar on Medicare Advantage and Spotlight on Market Access

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Jinghong Chen

Reporter, Health Plan Weekly and Radar on Drug Benefits

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Specialty Drugs
Specialty Pharmacy
Cell and Gene Therapies,
Drug Pricing
Benefit Design
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