The Payer Exchange Podcast Episode 11: USA Special - Jill Hanson
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Series 3 of The Payer Exchange takes a vacation to the United States, but with a global question in mind: how might changing US pricing policy affect market access, launch strategy and patient access elsewhere?
In the opening episode, Omar Ali speaks with Jill Hanson, VP of Regional Pharmacy at Centene Pharmacy Services, who brings a specialty pharmacy perspective to changes in drug pricing, contracting and medical benefit management, from one of the largest Medicaid managed care organisations in the US.
Jill’s discussion is grounded in practical payer operations: how formulary and contracting strategies may evolve as reliance on rebate maximisation reduces, how plans forecast high-cost therapies, and how medical benefit management and site-of-care optimisation can create value beyond unit price.
Key themes:
MFN, GUARD and GLOBE: implications for formulary and contracting strategy
Moving from rebate maximisation towards value-based agreement
Forecasting high-cost therapies and the potential for more dynamic pricing
Part B / MFP impacts on provider reimbursement and medical benefit management
Site-of-care optimisation and patient-centred delivery
“What I can say in terms of expectations from a commercial standpoint is that formulary and contracting strategies need to evolve with less reliance on rebate maximization.”
Share your perspective on The Payer Exchange
We’re always looking to hear from current and former payers, healthcare decision-makers and policy experts from around the world.
If you’d like to take part in a future episode of The Payer Exchange or join Verpora’s global payer network, get in touch with Omar Ali, Verpora’s Head of Payers, by email omar.ali@verpora.com or via DM on LinkedIn.
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About The Payer Exchange
The Payer Exchange is a podcast from Verpora exploring the people, policies and decisions shaping pharmaceutical market access around the world. Hosted by Omar Ali, Verpora’s Head of Payers, each episode features an in-depth one-to-one conversation with payers, policy experts and healthcare leaders, offering direct insight into pricing, reimbursement, access and the practical pressures shaping healthcare systems and pharmaceutical strategy.
At Verpora, we’re all about access strategy, and The Payer Exchange was developed as a way to share discussions we are having every day with payers, policy experts and life science organisations.
Verpora helps pharmaceutical companies bridge the gap between the value of innovation and the realities of healthcare funding. Through our global payer network, evidence, data and strategic market access expertise, we support better decisions, stronger partnerships and, ultimately, better patient access.
If this episode’s conversation has raised questions about your own challenges in market access, pricing, value-based agreements or innovative contracting, or you’d simply like to continue the discussion, we’d be delighted to hear from you - email omar.ali@verpora.com
Disclaimer: This presentation is for educational and informational purposes only, and is not intended as legal or policy advice. This presentation is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else or any organization. No part of this presentation may be reproduced for commercial purposes without the express permission of Verpora.