payer access the challenges

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PARIOFORMA Parioforma Ltd 55 Princes Gate London SW7 2PN United Kingdom www.parioforma.com With increased incidences of reimbursement rejections by payers and a growing usage of pricing and reimbursement tools market access is becoming increasingly restricted… In many markets, the process for gaining reimbursement is characterized by a health technology assessment (HTA) approach whereby payer organizations evaluate new medical technologies on the basis of their clinical value, cost- effectiveness and other health economic factors. Consequently, manufacturers of pharma products now face unique informational and evidentiary demands to demonstrate comparative value. Of all factors contributing to product success, payer access is considered the most critical – therefore, the sooner this is at the table, the more likely successful pricing and reimbursement strategies are to be realized.

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With increased incidences of reimbursement rejections by payers and a growing usage of pricing and reimbursement tools market access is becoming increasingly restricted…

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PARIOFORMA

Parioforma Ltd – 55 Princes Gate – London SW7 2PN – United Kingdom

www.parioforma.com

With increased incidences of reimbursement rejections by payers and a growing usage of pricing and reimbursement tools market access is becoming increasingly restricted…

In many markets, the process for gaining reimbursement is characterized by a health technology assessment (HTA) approach whereby payer organizations evaluate new medical technologies on the basis of their clinical value, cost-effectiveness and other health economic factors.

Consequently, manufacturers of pharma products now face unique informational and evidentiary demands to demonstrate comparative value.

Of all factors contributing to product success, payer access is considered the most critical – therefore, the sooner this is at the table, the more likely successful pricing and reimbursement strategies are to be realized.

PARIOFORMA

Parioforma Ltd – 55 Princes Gate – London SW7 2PN – United Kingdom

www.parioforma.com

Case Study:

A global pharmaceutical manufacturer contacted us to undertake an early environment mapping exercise in selected emerging markets – with particular focus on evolving HTA requirements

Key findings: Changing decision-makers – physician power is eroding.

Multiple buyers – all with different priorities and differing views about your product, adding complexity to the purchasing process.

Rise of new influencers – payer organisations and health technology assessment agencies are becoming gatekeepers.

Pricing pressure – intense pressure to contain costs and work within pre-defined budgets.

Stakeholder fragmentation – a broadened range of market access stakeholders.

Emerging markets are complex and evolving environments – political and economic transition has resulted in many changes in the healthcare environment of these countries.

Abbreviations:

CEA – Cost Effectiveness Analysis; CUA – Cost Utility Analysis; BIA – Budget Impact Analysis

PARIOFORMA

We specialise in payer research and environment mapping - quickly and affordably. With a network of over 500 payer specialists worldwide - our scope is global and we have the resources and experience to tailor our services to meet your needs…

Plan ahead and start early in the product lifecycle: Every market is different – payer profiling & environment mapping is key to helping manufacturers

understand the complex reimbursement, coverage and decision making landscape.

Studies need not be in-depth, early directional work can guide strategy development, help build early value messages and save time and money by ensuring that any future large global study asks the right questions and is not overly complicated.

We can help you:

For further information, or to discuss your Payer & Market Access requirements, contact us now on +44 (0) 207 225 3538 or email Charles

Rowlands at: [email protected]