Reimbursement & Patient Services Archives

Prescription Drug Spending and the U.S. Health Spending Gap Compared with OECD Countries

Prescription drugs represent only a small portion of the overall difference in health care spending between the United States and comparable OECD countries. In 2021, prescription drug spending accounted for approximately $550, or 9.7%, of the $5,683 per capita spending gap, while inpatient and outpatient services accounted for nearly 80% of the difference. Administrative costs represented about 12% of the gap, highlighting the significant role of system complexity and operational overhead in driving higher U.S. health care spending.

Market Access as a Driver of Biotech Value in 2026

Market access is increasingly shaping biopharma decisions earlier in the lifecycle. This article explores how policy uncertainty, evidence expectations, and access strategy are influencing development, investment, and long-term value realization.

Case Study: Educating on Combination Product Access

How a biotech company equipped HCPs to navigate acquisition, coding, and coverage for a dual-therapy regimen.

Case Study: Reimbursement & Market Access — Supporting Products with Required Imaging

How a manufacturer integrated imaging requirements into its access and patient support strategy.

Deal-Driven Policy, Direct-to-Patient Models, and State Momentum: Preparing for 2026

As policy dynamics accelerate across federal and state channels, manufacturers must prepare for multiple scenarios and align internal planning. Key readiness priorities for 2026.

Case Study: Strategic Coding Application Creates a Reimbursement Pathway for a Device Accessory

See how a smarter coding strategy helped a medical device company strengthen payer alignment and accelerate access.

Payer Research: A Strategic Driver of ROI Across the Lifecycle

Design research payers can use: focus on real-world outcomes, durability, and total cost of care; bring payer input in early and often; and pressure-test access levers pre-launch. Turn strong science into coverage, reimbursement, and measurable ROI.

Case Study: Building a Gold-Standard Market Access Framework for a First-in-Class Therapy

See how Magnolia Market Access helped a manufacturer overcome coding gaps, payer unfamiliarity, and site readiness challenges to launch the first FDA-approved therapy in a rare disease — creating a replicable, gold-standard access model.

How 340B Disproportionate Share Hospitals (DSH) are Failing to Reinvest in Patient Care

This issue brief provides insights into how 340B savings are being redirected by covered entities—particularly DSH hospitals—toward financial investments instead of patient care, underscoring the urgency of policy changes to realign the program with its mission.

MFN Policy Executive Order: What It Means for Pricing, Distribution, and Biopharma Strategy

On May 12, 2025, President Trump signed an executive order with the potential to significantly change the U.S. drug pricing and distribution system. Here is what we know about the Administration’s new Most Favored Nation (MFN) policy: