Our Products and Services

Reimbursement Intelligence Translates Insights into Actions

RI leverages the right information, at the product lifecycle moment, for the best solution:

  • Rx Scorecard™ – Quantitative assessment of drug value, relative to competitors, from a payer’s point-of-view.
  • HUB Excellence™ – Measure the impact of each HUB program element to design the most cost-effective support program using best-in-class and competitor practices.
  • RiQ™ – Customer-based, measurable assessment of field force reimbursement and access performance with a metric-based improvement program.
  • Foundational to Advanced eLearning – Managed markets training for field and internal teams, including implications of healthcare reform on your specific business area.
  • Pathway Tracker™ Measure drivers of oncology product adoption on pathways to prioritize brand-specific strategies and tactics.
  • Value Driver Management for Market Access™ – Systematically measure market performance in a therapeutic category against what’s most important to payers; gain strategic and tactical alignment across your marketing, market access, and commercial operations.
  • Custom Research and Tailored Training Programs – Leverage RI’s 2,000+ member Reimbursement Intelligence Network (RIN) to capture business insights from decision-makers in the ACO, PCMH, IDN, Payer, and Provider settings to refine your customer intelligence and to use up-to-date customer input to successfully engage all customer types.

Pathway Tracker™

Optimizing Product Use in Pathways

Pathways are a growing patient management strategy that payers and providers use to improve care quality while reducing costs. It is critical for pharma companies to understand the overall design and structure of pathways and the key drivers for product access at various treatment points.

There are multiple treatment points in a clinical pathway where decisions are made about the use of drugs. Pathway Tracker identifies and tracks the critical drivers that influence use of branded drugs at each of these points. RI uses the Pathway Tracker to develop brand-specific recommendations and tactics to improve or maintain access for your products.

Pathway Tracker is based on our extensive network of pathway designers, our deep experience in oncology and other therapeutic areas that use pathways, and multiple sources of primary and secondary research.

For more detailed information on our Pathway Tracker, please click here.


Value Driver Management for Market Access™

Driving Formulary Access and Placement

The VDM: Market Access solution is specifically designed to help executives prioritize activities which optimize formulary access and position. The solution identifies unique market by market opportunities and delivers a holistic view of each market that includes both approved and developmental competitive products.

It’s about Action

Align your team around reliable global indicators that predict formulary access and placement in each of the top established markets.

  • Identify the specific factors driving access and formulary position in each market
  • Monitor individual brand performance across your most important markets
  • Gain reliable competitive intelligence on market leading and developmental products

For more detailed information on our Pathway Tracker, please click here.

RiQ_logo_pngReimbursement iQ™

Building high-impact customer engagement in today’s payer environment

How can you ensure your organization consistently delivers best-in-class service to current and emerging customers?

Your customers are changing like never before. Decisions about your entire portfolio are more frequently being made at the institutional level (ie, payers, Accountable Care Organizations), requiring your company to seriously rethink the way you engage key customers. Even pharmaceutical, biotech and device manufacturers who have historically been top performers will require critical adjustments around who they target, what they say, and how they deliver services in order to sustain success.

RiQ helps you build teams that have the expertise, skills and flexibility to meet your customers’ quickly evolving needs. Your organization will receive a seamless training program that allows you to measure your organization’s proficiency on key performance indicators (Diagnosis), develop a path for driving better customer penetration (Design), and accelerate performance on the exact dimensions where there is the greatest ROI (Treatment).

For more information on our RiQ™, please click here.

Rx Scorecard™

Putting the formula for market access in your hands

How do payers value a drug vs. its competitors? What would change their assessments?

Rx Scorecard™ is the first and only tool that assesses the value of drugs from a payer’s perspective—objectively,transparently, systematically.

Using our proprietary algorithm, in-depth analysis of publicly available data, and years of experience working in the P&T decision-making process at major payers, our team of pharmacists, statisticians and physicians “score” all the drugs in an indication on the 19 efficacy, safety, practicalities of use, and economic elements which define value to payers. Each element of the score is linked to the original research source—which means the results are completely, transparently supported.

In short, Rx Scorecard™ puts in your hands the intelligence, logic and necessary back-up to create productive discussions with payers—in their language, based on their concerns—not to mention providing a roadmap for the follow-on studies that will make a meaningful difference to your product’s market access.

Rx Scorecard™ is:

  • Web-delivered, interactive
  • Updated monthly
  • Fact-based; all data sources fully document
  • Customizable; can test/save scenarios
  • Objective and transparent

For more detailed information on our Rx Scorecard™, please click here.

Managed Markets Communication Tools

RI partners with our clients to deliver customer communications that inform, motivate, and integrate with provider and patient messaging platforms.

Full Service Communications Capabilities

RI offers full service customer communications with our team of writers and designers focused in the managed markets area. Our capabilities include traditional print as well as the latest digital technologies to increase customer participation and engagement, such as iPad tools and interactive video. Recent customer fulfillments include:

  • Branded and unbranded slide presentations (Product Value Propositions; Health Economics Outcomes Research (HEOR); Disease Management)
  • Clinical monographs
  • Brochures
  • White papers (Impact of Medicare Part D, Value-based Insurance Design)
  • E-print carriers

To learn more about our reimbursement training services, please contact Susan Raiola at sraiola@reimbursementintelligence.com or 973-805-2303.

HUB Excellence

Optimize Patient Support to Maximize Access

What will differentiate your services and improve brand performance?

Reimbursement assistance is critical to the commercial success of current and new therapies, especially expensive specialty products. Decisions regarding prescription fulfillment are often financially driven and have less to do with performance of a particular therapy. As a result, all life science companies have assembled patient and provider support programs (HUBs) that help patients and prescribers navigate and reduce barriers to access and reimbursement. Manufacturers must identify the program elements, channels and design that meet customer needs and differentiate their HUB services from the competition.

RI has developed HUB Excellence, an assessment tool to help brands optimize key services relative to the competition. HUB Excellence provides a view of customer needs and expectations for HUB services, creates a comparative view of service offerings, prioritizes and measures program performance for relevant branded drugs based on customer input, and provides regular market updates as competitor programs evolve. To act on these findings, RI offers a suite of programs including sales and call center messaging, field training, impactful communications, and eLearning modules. No matter where you are in patient support program development, RI uses HUB Excellence to form a fact-base for action to support all aspects of planning.

For more detailed information on our HUB Excellence, please click here.

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Winston WongWinston Wong, PharmD, President, W-Squared Group

Winston Wong, PharmD, is the President of the W-Squared Group. The W-Squared Group is committed to assist healthcare innovators to launch their technology in the government and commercial marketplace. He is known for his clinical innovations throughout his 30-year career.  Among his accomplishments are participating as a member of the APhA STAT committee first addressing the value of MTM services, implementation of a provider network Pay-for-Quality program in Oncology and Rheumatology, and incorporating MTM services into the overall Medical Management Strategy in a health plan.

He earned his PharmD degree in 1981 from the University of the Pacific in Stockton California, and completed a General Residency at the University of Nebraska Hospital and Clinics in Omaha, Nebraska. Since earning his degree, he has held numerous staff, clinical, and leadership positions in hospital, GPO, and managed care settings.

john whangJohn Whang, MD, FACC, COO, President of Market Research, Reimbursement Intelligence

John Whang is a board-certified cardiologist with experience in both clinical and corporate environments. Prior to joining RI as COO, John was a senior consultant at McKinsey&Company in its Health Care Practice. He led and conducted multiple studies with pharmaceutical, medical device, payor, and provider clients; he also led due diligences on behalf of private equity and venture capital firms in their assessment of potential targets. While at McKinsey, John established McKinsey’s first Advisory Board of world KOLs in cardiovascular diseases that equipped them with resources to offer as an additional competency to raise its profile of unique consulting services.

Before McKinsey, John was Director of Non-Invasive Cardiovascular Services at Morristown Medical Center in Morristown, NJ, which is the second largest cardiac program in the Northeast. John managed all aspects of inpatient and outpatient cardiovascular services while actively practicing cardiology. He led the introduction of cutting-edge technologies such as intra-cardiac echo (ICE) to enable the growth of innovative catheter-based programs including PFO closure and transcatheter valve.

John received his MD from the College of Physicians and Surgeons, Columbia University and an AB in evolutionary biology from Harvard College.

Webinar: How to Select Appropriate HCV Therapies

Speakers: Winston Wong, PharmD, President, W-Squared Group and
John Whang, MD, FACC, Co-President, Reimbursement Intelligence
Recorded on: Tuesday, May 20, 2014

Check out some highlights from our webinar:
RxScorecard: A Structured Approach to the Evaluation of HCV Regimens From the Customer Perspective

Click here to download the full presentation.

Know your options for lowering costs and improving outcomes in the evolving treatment landscape for HCV

HCV Landscape: New HCV drugs are revolutionizing therapy while playing havoc with payer finances. Even the biggest plans are dealing with huge, unexpected budget increases – and struggling to ensure their members have access to the most appropriate therapy.

Webinar Overview: Real Endpoints’ Payer Advisory Team will review the key efficacy, safety, usage and economic evidence for the nine key marketed and pipeline HCV regimens – and implications for how best to deploy them in the relevant HCV subpopulations. 

Webinar Objectives:
Participants will see how they can:

  • Efficiently and effectively evaluate HCV regimens relative to one another based on in-depth review of published evidence for efficacy, safety, and economics in all genotypes and all key patient sub-populations
  • Select regimens which improve outcomes and decrease overall costs by aligning appropriate therapies with subpopulations
  • Uncover category management opportunities that contain costs while supporting high quality care
  • Use early stage data (i.e. Phase II) to develop a pipeline roadmap for P&T committees and payer decision-makers regarding current and future coverage decisions
  • Quickly run scenarios to determine impact of changing plan priorities on formulary decisions


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