Market Access, Pricing and Reimbursement Solutions

Securing market access is integral to optimal product development, commercialization, and life cycle planning. We collaborate with life sciences clients to help develop and integrate market access insights into clinical and commercial decision-making.  

We combine health economic expertise with knowledge of local and regional markets, and build upon that experience with healthcare modeling and analysis, to identify and substantiate value drivers for products in development. Through stakeholder mapping and highlighting unmet needs, analyses of funding flows and third-party payment policy analysis, and value proposition optimization, we assist clients in defining and developing differentiated products through our value substantiation and quantification solutions.

Global and U.S. Specific Strategy, Evaluation, and Planning Solutions:

  • Stakeholder mapping/funding flow analysis
  • Value proposition optimization/evidence planning
  • Strategic Reimbursement Assessments (SRAs) including third-party coverage, coding, and payment landscaping
  • Strategic Market Assessments (SMA)
  • Mock payer, formulary, and value assessment committee negotiations
  • Pricing strategy (including quantitative pricing analyses, formulary positioning, benchmarking)
  • International price reference modeling
  • Contracting strategies to support value-based pricing and purchasing

Go to Market and Commercialization Solutions:

  • Comprehensive market access launch planning and sequencing analyses
  • Payer engagement and policy development, legislative analyses, and advocacy
  • Coding applications (e.g., ICD-10, CPT, HCPCS) and customer billing support
  • Analyses and re-calibration of prospective payment systems (PPS) and fee schedules for new and existing patient episodes, products, and services
  • Applications for new technology add-on payments (NTAP), new technology ambulatory payment classification (APC), and transitional pass through (TPT) status
  • Payer formulary and coverage policy monitoring and surveillance
  • Healthcare Economics and Outcomes Research (HEOR) and Real World Evidence (RWE) studies
  • Provide impact analyses including time and motion studies, workflow assessments, and P&L modeling
  • Global and regional value dossiers including AMCP formatted versions
  • Budget impact models, cost and cost effectiveness analyses
  • Hub reimbursement services including hotlines, appeals programs, and other support services

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