Integrated Delivery Networks
NEED FORM! Thought Leadership Whitepaper: How Will Medicare Drug Price Negotiations Really Impact Providers?
Author:
Emma Bijesse
Feb 14, 2025
Emma Bijesse supports HMP Market Access Insights quantitative and qualitative research with over 10 years of experience supporting academic health systems and integrated delivery networks. Emma’s previous experience includes leading strategy engagements as an Associate Principal at Chartis, including oncology service line growth planning, partnership support, and financial forecasting and analyses. Prior to Chartis, Emma supported genetic testing and population health management programs at Kaiser Permanente. Emma holds an MBA from the Kellogg School of Management at Northwestern University, where she majored in finance and operations. She also received a bachelor's degree in economics from the University of California, Berkeley.
As manufacturers prepare for Medicare drug price negotiations, a critical question emerges: How will your provider engagement strategy evolve when Maximum Fair Prices (MFP) take effect in 2026? With discounts ranging from 38%-79% off the wholesale acquisition price (WAC), the provider buy-and-bill margin equation is about to change.
Our analysis reveals why manufacturers need to start planning now for this shift in provider economics and we explore how different manufacturer discount approaches could impact buy-and-bill provider margins. Understanding these dynamics is crucial for maintaining strong provider relationships during this transition.
Key insights include:
- Strategic considerations for structuring provider discounts in an MFP world
- Why early signaling to providers regarding discount methodologies matters
- Importance of considering scenarios with varying provider, competitor, and PBM responses for manufacturers with brands competing against a product with MFP pricing
Complete the form below to download our full analysis to understand how these changes could impact your provider relationships and what steps to take now.
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