A Multidisciplinary Approach to Pricing and Reimbursement

MattsonJack's Pricing and Reimbursement specialists take a multidisciplinary approach to pharmaceutical pricing and reimbursement in order to develop integrated solutions for our clients.

Pharmaceutical benefit costs are rising and payers increasingly pass costs on to patients or restrict access through step therapies and prior authorization requirements. Federal involvement in prescription drug coverage threatens to increase pressure on drug pricing. The Medicaid Best Price, 340B, and Part B programs are examples of how federal activity reduces manufacturers' ability to adjust prices. Understanding how pharmaceuticals are priced within the product distribution chain is critical for commercial success. Critical issues include:

• demonstrating value with superior safety, efficacy, cost-effectiveness, and improved outcomes
• better understanding of health economics and outcomes to optimize product positioning
• developing a winning value proposition Reimbursement and Pricing with payers to optimize pricing and reimbursement

MattsonJack provides services in:

Pricing & Reimbursement

• tracking and analyzing changes in injectable drug reimbursement by Medicare, managed care payers, and others
• evaluating managed care payers' management strategies for both injectable and oral drugs
• analyzing and predicting policy and specific payer practices at national, regional, and local levels, and constructing novel patient and payer segmentations:
  • profiling various provider types or stakeholders nationally or regionally, assessing provider interactions and "power," recommending appropriate marketing and sales strategies, convening / moderating expert panels to discuss emerging legislation or key provider issues
  • building economic input-output models
  • examining pricing trends

Government Policy and Trends

• alerting clients to critical changes in policy that impact the cancer drug business
• identifying resulting hurdles threatening to impact you directly

Competitive Landscape Assessment

• assisting in monitoring external environments, issues, and trends that drive effective strategies and tactical implementations

For more information, phone MattsonJack at (650) 212-7010 or e-mail info@mattsonjack.com.