A physician administered biologic is facing its first competitor and needed to defend its market share and maintain its competitive edge. Multiple competitors were also expected to enter the market within the 3 year horizon.The client needed to determine a go- no-go decision of engaging payers with a contract offer. ASP assessments were also conducted to minimize physician impact. Understanding the delicate balance required between competitive offense and defense is critical. We tested payers likely reaction to both clinical and financial considerations, testing payers’ sensitivity to competitor clinical profile and rebates using different price/contracting scenarios. In this project, it was important to consider the advantages of incumbency status created by the client’s existing market share. We recommended a contracting strategy that resulted in the client’s ability to maintain its share above 95% 10 years post entry of competitors. Our strategy was accompanied by an implementation plan which comprised: establishment of triggers to ensure appropriate and efficient contracting, determination of a segmentation framework to prioritize efforts, and development of a manual for account managers to train on the strategy and application of negotiation tactics.
A large manufacturer has been using an ad-hoc contracting strategy for its self-injectable biologic. The company was seeking to optimize market penetration and revenue in a competitive environment through a targeted contracting strategy.Rebate contracts require periodic reviews to determine its effectiveness in achieving its goal. An extensive quantitative analysis was performed on existing rebate contracts and market share within those accounts to determine ROI of contract rebates offered.We optimized the manufacturer’s rebate contracts through, prioritizing productive accounts and highlighting accounts where rebates where not effective in delivering expected market share.
A client was preparing to launch a high-priced self-injectable for an orphan indication. The client asked us to develop a patient assistance strategy.We profiled patient assistance strategies used by other orphan drugs and identified steps to set up a successful patient assistance program. Product was launched with a comprehensive patient assistance program based on our recommendations.
A large manufacturer is launching a physician administered oncologic agent in a competitive space.The client was seeking a partner to assist in ensuring the organization’s readiness for launch in key channels. We reviewed existing research and previously conducted analysis to aggregate baseline understanding for each channel. The brand plan was reviewed to understand brand objectives at launch. Payer interviews were conducted to supplement gaps in channel perceptions and objectives. A moderated client session was conducted to review findings and refine CSFs and key initiatives for each channel.We defined requirements for success in the following payer channels: Commercial, Medicare, VA/DoD, Medicaid, GPO/SPP. Critical success factors were delineated and action-oriented initiatives were developed in each of the targeted channels. Roles and responsibilities were also outlined for each key initiative.
A biotechnology company was preparing to launch an oral agent for a cancer indication with multiple treatment options. The client wanted to understand how access decisions are made and who the influencers are at each step in the process. We conducted payer interviews to map out access decision process and influencers at each step. Findings were validated by client interviews and workshop with account managers. We created an influence map for key regions and identified opportunities to proactively enhance access for its oncology agent.
A large manufacturer wished to understand the payer mix of its physician-administered specialty product with multiple indications. Client engaged us to develop a Payer Mix Analysis using inpatient and outpatient medical and pharmacy claims data. We took the lead in identifying data sources and acquiring data beyond the client’s contracted data sources. We created rules for ‘stitching’ the data together on a common basis and executed the necessary analytics. Our analysis and reports were used to assess the cost-benefit of sales efforts in different regions.
New entities are emerging to improve cost, health outcomes and patient experience in the wake of healthcare reform. These partnerships are leading the way in reimbursement and care model innovation. The client is conducting an ACO Pilot Initiative in one of its therapeutic categories to better design its long term ACO strategy.The client engaged us to assess the client’s current ACO strategy, develop program offerings for the initiative, and to prepare the organization by understanding roles and responsibilities for this new customer base. An intensive working relationship with the client was structured to ensure aggressive timelines were met. A cross-functional core team was developed to ensure key functions were represented. Two phases were defined for this ACO Pilot Initiative: Planning and Implementation. These phases included: a) a critical assessment of the client’s current ACO strategy, refining strategy components as necessary; b) consensus building and buy-in to the implementation plan among client stakeholders; c) development of an implementation plan, supported by tools to guide the organization towards successful roll-out of pilots; and d) development of detailed program offerings for ACOs; d) support and monitoring of engagement progress with identified key ACO targets.
A client expected to launch its first biologic product in 18 months. We were retained to help the client plan, prioritize and coordinate pre-launch activities.Calling upon our extensive experience in biologics, we crafted a detailed work plan with roles, responsibilities, timelines and milestones. We provided a Planning Manager to help the client’s team monitor and coordinate activities against the plan. We also assisted with skills development for the account management, reimbursement and patient services teams.
A company with a self-injectable in a heavily managed category was expecting a competitive launch. Competition was the first oral treatment option in the disease category. Company engaged us to develop a payer strategy for their product at different pricing points of the competitive product. We interviewed payers to determine potential differences in access and coverage of the client’s product at various clinical product profile and pricing of the competitive product. Taking into account our findings with multiple facets of the competitive landscape, we recommended targeted contracting and value messaging payer strategies at each competitive pricing scenario.
Client was facing a potential new competitor.Client engaged us to develop and execute on a strategy that would optimally position its product for the competitive entry.After we developed competitive offense strategy with the client, we met with client to set up the working structure and facilitated working sessions with key cross-functional stakeholders. We created a detailed Gantt that details activities, responsibilities, timelines and milestones to ensure timely completion of tasks. We managed execution of the work streams through regular communication and periodic meetings to report progress.
A pharmaceutical company was preparing for the launch of a first-in-class biologic.Client engaged us to develop a compelling presentation that will demonstrate the value of its product with payers and support favorable formulary positioning.We crafted the product messaging strategy and developed presentations of clinical, outcomes and cost effectiveness data aligned with appropriate publication references. Conducted individual, web-assisted payer interviews to gather feedback and assessment of the value proposition, including needs for supportive data or value-added programs.We developed a payer value proposition presentation for account managers, sheparding the presentation through the regulatory/legal/compliance process.
A small pharmaceutical company was launching its first product in 10 months and did not have a managed markets team. Our client asked us to design a payer facing medical science liason team, a payer account management team, and a government affairs team. We identified unique needs for their product and resources needed to cover targeted accounts through primary and secondary research with internal brand team and payers. We established a dedicated account management team to cover managed care, trade, and government. In addition, we determined coverage objectives for the team and developed a traning tool for its account management team. Our client achieved its target coverage with its first product.
A small pharmaceutical company was preparing for two launches in rapid succession.The client asked us to prepare the organization for the launch with limited resources. We developed a proprietary account management organization development model that reflects the product’s lifecycle, account prioritization, trends affecting customer management needs and benchmarked workloads.We defined size, structure, required skills, performance measures, communication plan, technology capabilities and decision-making processes for the organization. We established a clear mission, strategy and critical success factors to guide the account management team and realigned their account management efforts.
The managed markets team at a large specialty pharmaceutical company was preparing marketing plans for the following year for select products.Our client asked us to facilitate the marketing strategy development process.We facilitated workshops to understand and prioritize trends in the market; to isolate key issues to be addressed; and to finalize strategies for those identified issues. We presented the updated marketing strategies to the brand team, who in turn will develop marketing tactics accordingly.