Project Highlights

Evaluating a New Technology

Situation

Our client, a venture capital firm, requested an evaluation of how a stem cell implant technology would be received by payers. The pricing strategy was also evaluated to determine how the product would be restricted at various price points.

Plan of Action

Reimbursement Intelligence (RI) spoke with Managed Care decision makers, including Medical and Pharmacy Directors, to gain detailed feedback on the expected efficacy, safety and pricing of the drug. We also presented the current clinical trial protocol to understand what additional health outcomes data would be requested.

RI also presented various pricing scenarios to analyze how it the price will impact coverage and other reimbursement restrictions such as prior authorization and step therapy.

Results

When the process was completed, RI delivered recommendations via a long-term reimbursement plan that maximized revenue and profitability. The plan also identified the resources, budgets and timelines necessary for the venture capital team to fund appropriately.