Build Cross-Functional Support for Medicaid Pricing Activities

Sarah Ray, regulatory affairs and safety researcher
By Sarah Ray,
Senior Research Analyst

According to a Cutting Edge Information study, attaining favorable Medicaid pricing remains a key factor in life science companies’ market access preparations.  Broadly, government payer acceptance often sets the precedent for whether private payers will reimburse company products or not. Unsurprisingly, private payers are less likely to support products that fail to meet government approval. As one market access advisor explained, “Failure to receive Medicaid coverage is like a kiss of death for company products.”  Subsequently, market access teams work diligently to ensure that drugs attain Medicare and Medicaid reimbursement. Continue reading

Drug Safety Data and HEOR Driving Clinical Trial Costs and Time

Ryan McGuire, lifecycle management tactics expert
By Ryan McGuire,
Research Analyst

The healthcare marketplace has seen seismic shifts over the past five years.  Austerity measures have strained the reimbursement climate in many EU countries and driven government payers to scrutinize every new drug as never before.  Healthcare reform in the United States has the potential to add coverage for 30 million uninsured Americans.  As a result, pharmaceutical companies are working even harder to gain favorable formulary placement with private payers. Continue reading

A Method to the Madness: Managed Markets Account Managers

Jacob Presson, pharmaceutical market access researcher
By Jacob Presson,
Senior Research Analyst

As payers demand ever-increasing evidence of product efficacy and cost effectiveness from the pharmaceutical industry, managing relationships with them is growing in strategic importance.  As a result, account managers dedicated to delivering the right kind of data to payers are becoming more vital.  What do pharma companies need to do to maximize this interaction? Continue reading

Great Moderators Key to Pharmaceutical Advisory Board Success

Jacob Presson, pharmaceutical market access researcher
By Jacob Presson,
Senior Research Analyst

Pharmaceutical companies are evolving their advisory board strategies to keep pace with the rapid changes that the entire industry is experiencing. As payer demands increase in complexity, the importance of engaging payers to understand their needs is growing. The depth of outcomes data that payers need requires precisely targeted clinical trials to be effectively developed to meet these needs. As such, when a team is able to gather a roomful of experts together, the benefits from that time need to be maximized for both the participants’ and the company’s sake. One significant — and relatively simple — step that companies can take is to ensure that the moderator or co-chair is up to the task. Continue reading

Ideal Criteria for Finding Top-Notch Health Outcomes Liaisons

With the expanding emphasis on building payer relationships and demonstrating product value, health outcomes liaison and managed care liaison teams are more important than ever.  The first step to building a strong payer liaison team is to find the right HOL candidate. However, finding these candidates is difficult due to the unique combination of skills necessary to this role.  Companies must focus on the right blend of education, experience and training to ensure they have a strong payer liaison team. Continue reading

Want Top Formulary Postions? You’ll Need a Well-Armed Payer Liaison Team

Payer meetings are crucial to drug success.  Payer liaison teams, whether they consist of health outcomes liaisons (HOL), managed care liaisons (MCL), or any other medical/economic expert team, must convince payers of their drugs’ superiority to achieve top formulary positions and maximum patient access.  If they’re lucky, these teams will be allowed to visit with payer organizations once per quarter and often for only about an hour.  Facing such a pivotal reimbursement decision, the liaison teams must come well-armed. Continue reading