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Item Dynamics of biosimilar uptake in emerging markets(Taylor & Francis, 2022-05-22) Chhabra, Hemlata; Mouslim, Morgane; Kashiramka, Smita; Rathore, Anurag SIntroduction Globally, biosimilars are expected to play a key role in lowering healthcare costs and providing increased patient access to biological therapies. Given this, and in line with the European Union and World Health Organization, many emerging nations have adapted and established biosimilar regulatory guidelines. Emerging nations present a lucrative market for biosimilar development and commercialization, yet they also pose unique challenges. A thorough understanding of the unique attributes of emerging markets in relation to biosimilars is needed to promote their successful uptake in low- and middle-income countries. Areas covered This article highlights the opportunities and challenges that emerging markets represent in terms of biosimilar uptake. A comprehensive analysis of biosimilar uptake in European countries, where biosimilars have gained significant market share, was carried out to identify policies that can enhance market penetration in emerging nations. Expert opinion Implementation of pricing and procurement policies, as well as provider and patient confidence in biosimilar efficacy, are key factors in their uptake. Due to the high cost of biosimilar development, incentivizing domestic companies with the biosimilar manufacturing capability to produce these drugs will be helpful in ensuring a sustainable biosimilar market and a steady supply chain.Item States Experiment with Cross State Comparison to Evaluate Medicaid Waivers for Substance Use Disorder Services(Academy Health, 2020-01-30) Cunningham, Peter; Woodcock, Cynthia; Pauly, NathanItem Hospital Price Transparency: Will It Lead to Lower Prices?(The Hilltop Institute, 2021-08-23) Woodcock, Cynthia H.Item State Medicaid Agencies’ Multi-Faceted Response to the Opioid Epidemic(Academy Health, 2021-09-29) Cole, Evan S.; Kennedy, Susan; Raslevich, Amy; Burns, Marguerite; Clark, Sarah; Crane, Dushka; Cunningham, Peter; Jarlenski, Marian; Lanier, Paul; Middleton, Alice; Pauly, Nathan; Sheets, Logan; Talbert, Jeff; Donohue, Julie M.Context: Medicaid is the primary payer for substance use disorder (SUD) treatment in the United States. While some policy changes have been well documented, the operational decisions that guide the implementation of these policies have received insufficient attention. The objective of this analysis is to describe the roles that Medicaid programs have taken to address the opioid epidemic and their policy and operational decisions. Methods: We conducted 27 key informant interviews with state agency representatives in 9 states, all of which have been substantially impacted by the opioid epidemic. We focused our interviews on 3 distinct state roles: Regulator, Monitor, and Enforcer; Payer and Contractor; and Collaborator, Evaluator, and Educator. Within those roles, we aimed to synthesize the degree of variation of the policies implemented across these states from 2014-2019, given the breadth of policy levers available to them. Interviews were recorded and transcribed, responses were summarized categorically where possible, and the transcripts were reviewed to identify areas of variation. Findings: We observed substantial convergence in the policies and actions taken by states. All 9 states relaxed or eliminated utilization management policies, such as prior authorization of medications for opioid use disorder, that may be a barrier to access. Most states expanded SUD treatment coverage to align with the American Society of Addiction Medicine continuum of care. As collaborators, Medicaid programs participated in interagency efforts such as opioid task forces, including various levels of data-sharing between agencies. Interviewees discussed ongoing evaluative activities; however, OUD treatment quality measurement remains an area in need of development to support state policymakers.