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Access Read

Korea adds Pergoveris pen to reimbursement rolls, vial already covered

September 2, 2026 by Athithi Verma
Korea adds Pergoveris pen to reimbursement rolls, vial already covered

This is a device listing, not an eligibility expansion. The indication is unchanged, and the criteria were relaxed back in April 2025.

Categories Access Read, Market Access, Peptide, Pricing & Reimbursement, Quick, The Brief Tags Merck Group, Pergoveris, South Korea

CDA-AMC reverses course, backs Leqembi’s first ruling content still undisclosed

September 2, 2026 by Athithi Verma

Four words carry the news: follows a reconsideration. CDA-AMC reached a different conclusion first, and neither release says what it was.

Categories Access Read, Antibody, Market Access, Neurology, Pricing & Reimbursement, Quick, The Brief Tags Alzheimer’s Disease, Amyloid, BioArctic, Biogen, Canada, Eisai, Lecanemab, Leqembi, Market Access, Pricing & Reimbursement

Nine More Drugmakers Signed MFN Deals. The Coalition Formed to Fight Them Did Not.

September 1, 2026 by Athithi Verma
Nine More Drugmakers Signed MFN Deals. The Coalition Formed to Fight Them Did Not.

The useful information is who is absent. The mid-sized biotech coalition formed to contest MFN has no member among the nine signatories.

Categories Access Read, In Depth, Market Access, Pricing & Reimbursement, The Brief Tags Market Access, Pricing & Reimbursement

Korea Runs Three Reimbursement Speeds. September Shows All Three at Once.

August 28, 2026 by Athithi Verma
Korea Runs Three Reimbursement Speeds. September Shows All Three at Once.

The lane determines the timeline, and it is set long before you file. Model the Korean queue, not the approval date.

Categories Access Read, In Depth, Market Access, Pricing & Reimbursement, The Brief Tags Market Access

Abbott Cleared the First Dual Glucose and Ketone Sensor. FDA Judged Accuracy, Not Admissions.

August 28, 2026 by Athithi Verma

The label says diabetes. The clinical argument is type 1. Coverage conversations start from 2.1 million people, not 40.1 million.

Categories Access Read, Cardio-Metabolic, Digital Health, Quick, The Brief Tags Abbott, Continuous Glucose Monitoring, De Novo, Diabetic Keteacidosis, Libre Duo 10 Day, Type 1 Diabetes

This Money Buys Equipment, Not Operations. Your 2031 Answer Decides the 2027 Deal.

August 27, 2026 by Athithi Verma
This Money Buys Equipment, Not Operations. Your 2031 Answer Decides the 2027 Deal.

Half the pot is split equally, so award size is a weak proxy for market size. Your buyer is a state rural health office, not a hospital.

Categories Access Read, In Depth, Legal & Policy, Market Access, The Brief

Evernorth Adopts LOCUS in Three States, and States That the Review Process Is Not Changing

August 27, 2026 by Athithi Verma
Evernorth Adopts LOCUS in Three States, and States That the Review Process Is Not Changing

Three statutes across five years, discharged on one date. Evernorth says only the source of criteria changes, not the review process itself.

Categories Access Read, Legal & Policy, Market Access, Quick, The Brief Tags Behavioral Health, Evernorth, Medical Necessity, Mental Health Parity, The Cigna Group, United States, Utilization Management

DOJ Settled With the In-Home Vendor, Not the Health Plan, Over Four Medicare Advantage Codes

August 27, 2026 by Athithi Verma
DOJ Settled With the In-Home Vendor, Not the Health Plan, Over Four Medicare Advantage Codes

DOJ did not settle with a health plan. It settled with the in-home vendor that supplied the codes, and named the risk-share contract as the incentive.

Categories Access Read, Cardio-Metabolic, Legal & Policy, Quick, The Brief Tags False Claims Act, legal & Policy, Medicare Advantage, Monogram Health, Risk Adjustment, United States

China Will Pay One Price for 158 Conditions, Whatever the Hospital

August 26, 2026 by Athithi Verma
China Will Pay One Price for 158 Conditions Whatever the Hospital. Most of Them Are Drug-Led.

Same disease, same payment across tiers. Of 31 DRG categories, 27 are internal medicine, where drug cost rather than theatre time drives the case.

Categories Access Read, Cardio-Metabolic, Quick, Small Molecule, The Brief Tags China, DRG & DIP, Hospital Payment Reform, Market Access, NHSA, Pricing & Reimbursement

France Funded Two Cancer Drugs the Same Week. One Was Rated Therapeutic Progress, One Was Not.

August 26, 2026 by Athithi Verma
France Funded Two Cancer Drugs the Same Week. One Was Rated Therapeutic Progress, One Was Not.

Listing is granted by indication, not by licence. Columvi is funded for one situation and refused for the rest of its authorisation.

Categories Access Read, Antibody, Oncology, Quick, The Brief Tags Accord Healthcare, Columvi, France, glofitamab, HAS, Henlius, Hetronifly, Liste en Sus, Market Access, Pricing & Reimbursement, Roche, Serplulimab
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Synopulse Weekly Pulse: Access Decisions, Regulatory Events & Market Dynamics, Week of Nov 24 2025

Synopulse Weekly Pulse – November 24, 2025

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