Stakeholder Financial Perspectives for Brand Product Reimbursement
| Industry | Pharmaceutical Manufacturer |
| Problem | A manufacturer requested assistance reviewing the reimbursement criteria for one of their products and select competitors for each stakeholder in the pharmaceutical supply chain. |
| PHSI Solution | PHSL reviewed the brand's reimbursement rates through Medicaid, Medicare, and commercial insurance. PHSL generated dynamic financial models for both the pharmacy benefit and medical benefit to depict the impact on the different stakeholders. The unique lines of business were blended to examine the products across the spectrum of scenarios. |
| Results | PHSL compared the manufacturer’s product to the competitors’ products with the dynamic financial model results across the stakeholders. The manufacturer now had a transparent view into the financial drivers across different products in the therapeutic category and lines of business, and the dynamic model enabled alternative scenario evaluation and testing of the resulting impacts. |
Poll Results
August 2023 Question of the Month
What steps do you take when learning about an electronic prescribing challenge?
Root cause analysis: 0%
Compendia review: 0%
Engage a partner: 0%
All of the above: 50%
None of the above: 50%
July 2023 Question of the Month
Does your organization have a strategy for Humira biosimilar launches?
Yes, well defined: 0%
We have a framework: 50%
Waiting for clarity: 0%
No: 0%
Unaware of need: 50%
June 2023 Question of the Month
How far in advance of NDA/BLA expected approval do (or should) manufacturers begin planning their compendia submission strategy?
During Phase II Trials: 0%
Initiation of Phase III Trials: 66%
6 months prior to approval: 33%
3 months prior to approval: 0%
At time of approval: 0%
After approval: 0%
No strategy: 0%
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