{ Commercial Reimbursement and Formulary Placement }
Commercial Reimbursement and Formulary Placement
The first three hurdles for any drug are safety, efficacy, and manufacturing quality. The fourth hurdle is access and reimbursement. Many drugs that have passed the first three hurdles have failed at the fourth, never meeting their true clinical or market potential. In today’s world, the value proposition for access and reimbursement starts in Phase II with the inclusion of economic endpoints. Those endpoints form the basis for early models that ultimately support reimbursement through inclusion in dossier submissions to entities such as NICE and US commercial formulary decision-makers. Our capabilities include the ability to translate our health economic offerings (burden of illness analyses, payer landscape and competitor mapping, budget impact and cost offset models, etc.) into products that support successful P&T submissions. In addition to payers, our team has experience working with employers and employer benefit managers, helping define the benefits of different formulary structures in terms meaningful to the employer audience (e.g., disability, absenteeism, etc.). To optimize utilization with your commercial payer and employer audiences, we offer the following services:
- Commercial payers
- Claims analysis
- AMCP dossier development
- Formulary kit development
- Formulary presentation development
- JMCP and AJMC publications
- Employers and Employer Benefit Managers (EMBs)
- Value proposition analytics
- Partnerships with Leapfrog®, national, and local business groups on health
- Employer- and union-based disease management
