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With the increasing pricing pressure and clinical performance requirements by different healthcare payers, one size fits all approach does not work in the current market access scenario. Definition of value varies according to the stakeholder group i.e. providers, regulatory agencies, HTA bodies, payers, and patients We provide a clear understanding of the value drivers as perceived by different payers in EU and US and thereby assist you to create a compelling value story for the key stakeholders.

Market Access strategy for different payer archetypes:

Segmentation and mapping of payers to different archetypes based on their specific criteria of assessment i.e. cost-effectiveness, budget impact, clinical effectiveness. This would enable designing effective market strategy for reimbursement in these markets. We also cover the reimbursement decisions and benefit ratings of competitor drugs by different health technology assessment bodies in EU5, US and Japan.

Comparator outcome profile research:

We capture the evolution of treatment paradigm including the current and emerging drug therapies. Also cover details of the benefit assessment and pricing decisions for the competitor molecules. Information on the clinical trial results, mechanism of action, route of administration, therapeutic positioning and regulatory milestones is included. We also give insight into the potential therapeutic targets for drug development.

Pricing and reimbursement:

We cover the detailed pricing and reimbursement scenario for a product in a particular geography. Provide help in understanding the value drivers and expectations of different stakeholders and role of health technology assessment bodies in the reimbursement decisions. Also included are the case studies on the reimbursement pathway for a similar therapy introduced earlier and the associated challenges in order to help the client to design their go-to- market strategy.

HTA decisions and benefit ratings for:

  • NICE (UK)
  • GBA (Germany)
  • HAS (ASMR and SMR) (France)
  • AIFA (Italy)
  • AEMPS (Spain)
  • SMC (Scotland)
  • ICER (US)
  • Chuikyo (Japan)

Payer Policy changes and implications:

We provide an overview of the changing payer preferences, concerns and evolving requirements. Also inform about the payer policies impacting the prescription and uptake of particular product. Estimates the future payer environment and drivers of change.

Innovative pricing and funding mechanisms:

With increasing pressure from payers and limitations in evidence development, many innovative payment mechanisms are being introduced such as outcome based reimbursement, annuity based funding etc. We provide examples of such innovative models and feasibility of their application in a particular disease.