Rapid pricing and reimbursement strategic review for a new commercial opportunity

Determining potential hurdles and opportunities for a client business development strategy

 

The challenge

Our client needed to understand the probable price points and reimbursement challenges for a potential business development opportunity.  The information was going to be used in a strategic go/no-go senior management meeting as part of an acquisition and investment decision; a rapid turnaround was essential.

The solution

We undertook a rapid ‘red flag review’ to determine the appropriate price points and identify any potential challenges.

The red flag review consisted of:

  • Secondary research to identify potential treatment comparators.
  • A review of global pricing databases to identify comparator price points.
  • A HTA review of the comparators to identify any potential reimbursement issues and determine if there were any potential patient populations or clinical trial endpoints that should be incorporated to optimise the product’s value offering from a payer perspective.
  • An internal workshop to assess the available evidence and to make strategic recommendations based on the product profile in order to achieve the recommended price.
  • Utilisation of our payer network to provide further insight.

Key results

Our research concluded that:

  • Competitor pricing was lower than the client was considering.
  • Key clinical trial end-points that were not in the proposed clinical trial design were identified in the HTA review.
  • The only opportunity to achieve reimbursement at the desired price point was by focusing on a patient sub‑population.

Value to the client

The rapid turnaround and presentation of our findings in a succinct and concise format enabled the client to quickly grasp the potential reimbursement challenges and opportunities, and to present clear recommendations to the senior management board.

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