• Custom Market Research and Analytics on the reimbursement landscape and specific concerns likely to affect your product, product line or development-stage opportunities.
• Rapid Response provides a real-time “pulse” with a panel of managed markets experts to obtain critical information for brand decision making and pipeline strategy.
• Syndicated Reports reporting the insights from payers on their evolving thinking about the latest scientific developments in key therapeutic areas in order to understand how they’re likely to respond with access and cost controls to the newest therapies.
• Training Programs for management and sales forces so they understand the reimbursement issues physicians and managed care executives care about most.
• Managed Markets Communication – delivering the right messages about your products so that payers can understand its innovations and make it accessible to physicians and patients.

P + T Advisor

Many plans include an “expert” physician (the P&T insider), who is an ad hoc consultant to P&T Committees or serves as an informal medical advisor for a specific therapeutic area.

Why are P + T Insiders Important?

RI’s P&T insiders may:

• Influence plans representing millions of covered lives
• Refine your Managed Markets strategic plan based on formulary updates
• Proactively prepare for and respond to future formulary reviews
• Serve as panel contracted for scheduled quarterly use

Who are these P + T Insiders?

P&T insiders are difficult to identify, but are extremely influential as brand advocates or opponents. RI has learned that insiders aren’t always “called on” physicians or KOLs; many times they are local practice physicians familiar with the plan. Insiders may not be high prescribers of the drug or even practice medicine in the same field as the product they are reviewing.

RI’s P&T insider panel is comprised of identified and profiled physicians. Our proprietary identification process validates their scope of influence from both the payers’ and the insiders’ perspectives to clarify their role and importance to the health plan, including:

• Type and frequency as advisors to health plans
• Prescribing habits
• Scope of influence by covered lives/plan

P&T insider provides feedback and guidance for critical initiatives throughout the life of your brand.

Pre-launch

• Prepare for formulary reviews at targeted health plans
• Plan for clinical and health outcomes “must haves”
• Develop effective Managed Markets “value” proposition
• Finalize pricing and contracting strategies
• Identify differences between payer and P&T
• Insider reviews of Target Product Profiles (TPP)

Post-launch

• Gauge response to negative or disadvantaged formulary position
• Gain competitive intelligence
• Protect from threat of generic or new market entrants
• Engage P&T insiders in ongoing research and advisory board activities to build advocacy
• Evaluation of Managed Markets and brand promotional materials
• Develop or identify additional candidates for KOL or managed care speaker bureaus

Rapid Response Service

RAPID Response is a quick turnaround research service that delivers critical intelligence for brand decision-making and pipeline strategy

• Surveys access targeted managed markets experts to ensure you reach the customer segments critical to your research objectives
• Quantitative and qualitative survey designs are offered at two levels

 RAPID Response offers flexible access options

Let RAPID Response help you quickly translate market insights into actionable results.

To learn more about RAPID Response, contact Jessica DiPaolo at jdipaolo@reimbursementintelligence.com.

Reimbursement Intelligence Network (RIN)

It’s not a product. And it’s not a service. But the Reimbursement Intelligence Network, or RIN, underlies much of the work we do – and keeps making us smarter about the world of managed markets. RIN is an extensively coded database of over 5,000 key decision makers in government and commercial health plans, integrated delivery systems, accountable care organizations (ACOs) and pharmacy benefit management companies. We’ve got all the people who directly make the formulary decisions – pharmacy directors, medical directors, but we’ve also got the people who are important influencers on access decisions, including office billing managers, hospital chief operating officers, quality improvement directors and case managers, employers and employee benefit consultants. We survey them regularly on behalf of our clients – and for ourselves. And because we talk to them so regularly, we’ve also learned how to talk to them: we know the right questions to ask to elicit actionable information, to get our clients closest to the truth about reimbursement, to what will happen to their product in the marketplace. And we also know which members of our RIN to talk with about your specific program: since the database is extensively coded, we can virtually instantly target the right RIN members. If your product is likely to be heavily used in a Medicaid population, for example, we’ll make sure we’re talking with RIN members who influence access in Medicaid – and that we’re not wasting your time (and coming up with misleading information) by surveying RIN members with no influence in that segment of the payer community.

The RI analytics team will focus on identifying the reimbursement landscape for the product or technology by speaking with members of the RIN, Reimbursement Intelligence Network. The RIN represents Managed Care experts from Medicare, Medicaid, and Commercial plans. We have the pulse of the market and have several unique services unparalleled in the industry. We have a database of more than 5,000 decision makers and can segment them based upon customer type, number of covered lives, demographics, or any other customized request.

Reimbursement RiQ Training

Maximize sales force reimbursement effectiveness

Our changing reimbursement landscape is demanding greater attention, with economics playing an increasing role in provider decision-making. Training on reimbursement issues is now a critical component for a sales force to remain effective in our value-driven healthcare marketplace.

Equip your Sales Force

Knowledge – Ensure your representative demonstrate understanding of the current and future reimbursement landscape, and respond appropriately to customer questions

Messaging – Deliver consistent and on-message information about reimbursement and access

Assistance – Act as liaison for providers and staff when implementing your own reimbursement assistance program

Resources – Become a go-to resource for providers and staff on reimbursement and access issues

Our Approach to Reimbursement Training

At Reimbursement Intelligence (RI), we take an integrated approach to reimbursement training. Working with your existing sales program, we can provide add-on training components or, when needed, build a program from the ground up. Each ensures our clients have targeted reimbursement tools for their specific needs. General information categories our clients often look for include:

• Drug Distribution
• Patient Assistance Programs
• Reimbursement in government programs
• Managed Care Basics
• Billing and Coding

Dynamic Training Vehicles

Our capabilities at RI include the latest technology platforms as well as more traditional training vehicles, including:

• iPad apps
• Live Workshops
• e-learning Training Guides
• Train-the-Trainers Programs

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

Managed Markets Communications

Reimbursement Intelligence (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.

John 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.

Jessica DiPaolo, MPH, Vice President, New Business Development

Jessica DiPaolo, MPH, joins Reimbursement Intelligence (RI) as Vice President, New Business Development, bringing more than 17 years experience in the healthcare industry solely focused on market research and strategic marketing. Prior to joining RI, Jessica was a Research Director with P\S\L Research, selected as the senior Research Director, Qualitative Research.  Jessica provided senior-level consultation on qualitative research planning across the company’s three business groups in New York, Montreal and London. Jessica’s prior experience includes consumer health education, where she was able to apply her certification as a health education specialist (CHES) to provide strategic oversight for the development of patient marketing and communication programs for pharmaceutical clients including Lilly, Novartis, Merck, and Schering Plough. Jessica began her healthcare career as a member of the Managed Care Division of Blue Cross and Blue Shield of New Jersey.  While with the marketing group, she was responsible for submitting data to support the Plan’s NCQA accreditation.  She then went to Merck-Medco, where she helped to build the company’s small to mid-size client subsidiary, Systemed.  As part of Systemed, Jessica oversaw the execution of new business proposals to grow the Plan’s small to mid-size client base. Jessica holds an MPH from Columbia University, Mailman School of Public Health, along with a BA with Honors in psychology from Rutgers College.

Can You Identify Physicians Standing Between Your Brand and Millions of Lives?
Date & Time: June 19, 2013, 12:00 pm – 1:00 pm ET
Cost: Free
Speakers: Dr. John Whang & Jessica DiPaolo
Click here to register

• Who are the ad hoc physician advisors to formulary decision making?
• How can we understand the role and participation of these advisors in determining product placement on formularies?
• How will our brand be supported or evaluated by these key stakeholders?
• What messaging is required to grow and protect our brand from current and future competitors?

Oncology, multiple sclerosis, diabetes — these are some of the areas that are seeing the impact of rapid pipeline growth from pharmaceutical companies. Even in cardiology, with the impending arrival of monoclonal antibodies for cholesterol lowering, there is a burst in growth in new and complex drugs. As a result, health plans need to rely on physician advisors to help with formulary decisions. These advisors can be low prescribers and not called on by representatives; they can even be non-specialists in a specialty disease area. Their input and guidance to formulary (P&T) committee decisions can impact access of your products to millions of lives.

Reimbursement Intelligence has developed the P&T Advisor™, a product that allows you to identify and profile under-the-radar advisors who have influence over market access to your portfolio. Learn more during our complimentary webinar on June 19, 2013. Click here to register.

 Download may take a few minutes.

Susan Raiola, VP, Training & Communications , Reimbursement Intelligence

In 2006, Susan built our managed markets training solutions division. She developed a landmark training solution – RiQ™ (Reimbursement IQ), a new model for reimbursement sales force effectiveness. She works with small and large pharmaceutical companies to develop custom, targeted, and strategic training programs. As an expert reimbursement trainer, she is able to create programs that will not only identify and target gaps, but also create sustainable and scalable training programs for our pharmaceutical and biotech clients. Susan’s passion and energy will ensure that the RiQ™ becomes an integral part of your organization’s sales force effectiveness initiative. Her clients value her insights and unparalleled customer service. Susan began her career as a financial analyst for Prudential, eventually managing a division responsible for individual insurance financial analysis and projections. Susan holds a BS in Finance from Seton Hall, from which she was graduated summa cum laude.

John 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.

Free download of the webinar presentation from Reimbursement Intelligence

Speakers:     Dr. John Whang & Susan Raiola

Recorded April 17, 2013 – Download presentation here

Think your reimbursement support meets your customers’ needs?
If you don’t know your Reimbursement IQ, then you’d better think again!

Reimbursement hurdles comes with a bigger price tag to manufacturers than ever before. Physicians have neither the time nor the financial resources to deal with reimbursement headaches. And manufacturer support programs do not always provide the right solution.  Just the perception of a reimbursement hassle can prevent a physician from prescribing your brand. EVER.

The webinar revealed:

How practice-level dynamics can significantly hinder revenue, even when your product is covered

Why your investment in patient support resources may result in lost sales opportunities

How your organization can build reimbursement competency by more effectively collaborating across business units

Who Benefits:

• Executive Leadership
• Marketing, Brand Management Executives
• Sales Leadership
• Training Directors
• Managed Markets Executives

If you have any questions regarding the presentation contact Christine Irish at Cirish@reimbursementintelligence.com or 973-805-2300

Reimbursement Intelligence hosts webinars featuring our analysts and other industry leaders in the pharmaceutical, biotech, diagnostic and medical device industries.

The webinars focus on issues that are central to understanding the impact of current and emerging reimbursement and access trends in some of today’s most challenging markets.

Reimbursement Intelligence P&T Advisor™: Can You Identify Physicians Standing Between Your Brand and Millions of Lives?

• Who are the ad hoc physician advisors to formulary decision making?
• How can we understand the role and participation of these advisors in determining product placement on formularies?
• How will our brand be supported or evaluated by these key stakeholders?
• What messaging is required to grow and protect our brand from current and future competitors?

Date & Time: June 19, 2013, 12:00pm – 1:00pm ET
Cost: FREE
Speakers: 
John Whang, MD, FACC, COO, President of Market Research, Reimbursement Intelligence
Jessica DiPaolo, MPH, VP, Business Development, Reimbursement Intelligence

Click here to register.

Past Events:

Recorded April 17, 2013
Improving your Reimbursement (RiQ)—The Secret to Increasing Sales Performance

Speakers: 
John Whang, MD, FACC, COO, President of Market Research, Reimbursement Intelligence
Susan Raiola, VP, Training & Communications , Reimbursement Intelligence

Think your reimbursement support meets your customers’ needs?

Reimbursement hurdles come with a bigger price tag to manufacturers than ever before. Physicians have neither the time nor the financial resources to deal with reimbursement headaches. And manufacturer support programs do not always provide the right solution. Just the perception of a reimbursement hassle can prevent a physician from prescribing your brand. Ever….learn more

Please click here to download the presentation by Susan Raiola, VP, Training and Communications and John Whang, MD, FACC, COO, President of Market Research, Reimbursement Intelligence.

Recorded Dec. 5, 2012
Reimbursement Intelligence Webinar: Learning to say no: US Payers’ Changing Attitudes Toward Oncology Reimbursement

Speakers:
Ellen Foster Licking, Senior Analyst, Real Endpoints
John Whang, MD, FACC, COO, President of Market Research, Reimbursement Intelligence

It’s the biggest area of pipeline growth for pharma – and the fastest growing area of expense for most payers.

In Europe, payers have learned to say “no;” in the US, payers are in effect saying “no” through mechanisms that direct providers to make more economical choices: palliative care, clinical pathways, and new provider payment models, to name a few….learn more

Please click here to download the presentation by Ellen Licking, Senior Analyst, Real Endpoints and John Whang, MD, FACC, COO, President of Market Research, Reimbursement Intelligence.

High Cost of Cancer Drugs: HMO Executive, Oncologist, Highlight Key Issues in Reimbursement Intelligence Broadcast
Recorded: October 25, 2011

Speakers:
Dean H. Gesme, Jr. M.D., F.A.C.P., C.P.E., Assistant Principal Investigator, Cedar Rapids CCOP
John Fox, M.D., Associate Vice President, Medical Affairs, Priority Health

Oncology drugs traveled under the managed care radar screen for many years, but commercial and government payors alike now view these medications as potential budget busters and are launching new payment models to address escalating costs.

As payors become more proactive in managing the costs of cancer care, community practice oncologists, already dealing with government-mandated caps on drug-cost markups, continue to face significant economic pressures that threaten the sustainability of their business operations.

How can these two stakeholder groups cooperate to deliver high-quality patient care while keeping costs under control? Learn more..

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