Pricing & Value
Deploying advanced pricing and contracting strategies, we empower healthcare stakeholders with robust payer solutions and value propositions tailored for a complex market landscape
Payers: A Small Word Has a Lot of Meaning
For our clients, the concept of the payer is ever-evolving. For example, hospitals have become increasingly focused on managing their own formularies and utilization of products, while oncology practices continue to be swallowed up by large health systems expanding their 340B footprint. These different players all view coverage and payment from their own lens. Your value story has to be cohesive and appealing to all.
Strategy: Develop an evidence-based story to differentiate your product value for a broad spectrum of payers, including health systems and insurance providers.
Payer Value & Pricing Tactics
Use all available data to build a value story that reflects both strong core positioning and flexibility for targeting to differing customer segments
Develop and refine value messages with data and insights
Gain stakeholder feedback through payer and KOL interviews and meetings to identify potential obstacles and weak spots
Conduct internal client workshops to gain organizational alignment across all departments
Pricing and Contracting Strategies
Our clients know that payer contracting is opaque, and establishing a comprehensive pricing strategy is layered with more complexities than ever before. It is important to understand how pricing and contracting strategies are evolving, and will continue to evolve in the coming years.
Medicare price negotiation under the Inflation Reduction Act of 2022, pressures to reform PBM contracting policies, vertical integration among large national payers in Washington DC, and multiple understandings of the definition of “value” all should be considered in contracting.
Strategy: Build a knowledge base to justify the best possible contracting outcomes.
Strategic Contracting & Pricing Tactics
Understand the market landscape To Develop Competitive pricing and contracting strategies
Build and test pricing and contracting models
Complete gross-to-net calculations based on contracting
Use learnings from research to refine the value proposition and develop budget models
Create payer tools that Drive product coverage and uptake
When is the right time to start thinking about demonstrating value to payers?
It’s never too early in the product life cycle to think about how pharmaceuticals and medical devices can bring value to patients, providers, and payers. Fortunately, we support your value and access objectives from pipeline through loss of exclusivity.
Our team can support multiple avenues to demonstrate value to payers, including:
Value Proposition & Presentations
AMCP Doisser Pre and Post- Approval
Payer Tools
Payer interviews and advisory boards
Payer Engagement Pre and Post-Approval
Pricing and Contracting Strategy