Pricing & Reimbursement

Landscape Assessment

Scope of service:

• Trend and competition analysis: A market trend analysis will be conducted and the research will encompass an evaluation of competing products, their strengths and weaknesses, and market shares.

• Regulations and reimbursement: The identification of key legal requirements, reimbursement barriers, and potential financing pathways will be undertaken.

• Stakeholders: The identification of key decision makers, opinion leaders and other stakeholders influencing the market awareness and reimbursement process will be made.

• Pricing and reimbursement strategy: A market entry strategy will be developed for the product, with consideration given to its specific characteristics, competition, regulations, and payer expectations.

Benefits:

• Complete market overview: Key information about the market, competition, and reimbursement opportunities will be provided.

• Greater chance of reimbursement: In order to facilitate the adaptation of strategic approaches to the requirements of regulators and payers, the necessary support will be provided.

• Effective strategy: An optimal approach to pricing and reimbursement will be formulated, thereby increasing the chances of achieving market success.

Product positioning strategies

Scope of service:

• Assessment of the clinical value of the product: The clinical value of the medicinal product will be assessed in comparison to alternative products based on a synthesis of published and unpublished clinical trial results, the characteristics of the medicinal product itself, and other available data.

• Unique product features: The unique features of the product that will distinguish it from the competition will be defined.

• Place in the therapeutic/diagnostic regimen: The determination of the optimal place for the product in the therapeutic/diagnostic regimen will be made based on clinical guidelines, consultations with clinical experts and patient organisations.

• Target population size and reimbursement conditions: The determination of the target population size, the potential reimbursement conditions, and the impact on the public payer's budget if the product is reimbursed, will be conducted.

• Strategic recommendations: The preparation of recommendations regarding product positioning strategies, tailored to specific customer needs, will be undertaken.

Benefits:

• Product positioning: A precise determination of the product's place in the therapeutic regimen will be made, taking into account both clinical data and the expectations of physicians and patients.

• Optimal reimbursement strategy: the analyses will provide the information necessary to develop an optimal reimbursement strategy.

Pricing strategies and risk-sharing schemes (RSS)

Scope of service:

• Pricing strategies: Support is provided in the development and implementation of pricing strategies with the objective of obtaining preferable financing terms for reimbursed medical technology for the client.

• Competitive product assessment: A competitive analysis of products in the market will be conducted to establish a price benchmark, and comprehend the pricing strategy employed by other market participants.

• Risk-sharing schemes: Participation in the development and negotiation of risk-sharing agreements can be undertaken with the objective of optimising financial risk on the client's side.

• Decision support: Calculation scenarios are provided to facilitate decision-making and price negotiations.

Benefits:

• Increased chances of success: Our assistance in formulating and implementing effective pricing strategies and risk-sharing agreements increases the likelihood of obtaining a positive reimbursement decision.

• Increased product availability: The implementation of appropriate pricing strategies and risk-sharing agreements contributes to the enhancement of the accessibility of medical technologies for patients.

• Preparation for negotiations: In order to facilitate optimal preparation for price negotiations with the Economic Commission, we undertake a comprehensive analysis of all potential scenarios.

Analysis of reimbursement pathways

Scope of services:

• Identification of possible reimbursement pathways: In accordance with prevailing legal regulations and market experience, the available reimbursement pathways that are deemed to be applicable to the product under evaluation will be presented. The possibility of emergency access to medical therapies is a factor that will be given due consideration.

• Opportunities and threats of individual solutions: The identification and description of the advantages and potential disadvantages of potential reimbursement pathways will be conducted.

• Recommendation: A clear recommendation is thus presented, one which considers the possible consequences of choosing particular solutions.

Benefits:

• Solution Map: A clear map indicating all potential reimbursement pathways.

• Choosing the right pathway: Support for the decision-making process regarding the selection of a reimbursement pathway, based on reliable analysis of the opportunities and consequences involved.

Negotiating with the decision maker

Scope of services:

• Negotiation strategy: A comprehensive negotiation strategy will be prepared, tailored to the specific nature of the product and the Client's pricing strategy.

• Negotiation calculator: The development of analytical materials to support the modelling of various negotiation scenarios will be undertaken.

• Support during negotiations: We will provide professional support during meetings with the Economic Commission, participating in negotiations as the client's advisor.

• Documentation preparation: The necessary documentation and analyses will be prepared at every stage of the negotiation process.

• Optimization of reimbursement terms: We will assist in determining the most advantageous reimbursement terms, considering both the objectives of the business and the requirements of the payer.

Benefits:

• Effective negotiation strategy: Professional support will be provided in the development of a reimbursement strategy.

• Substantive preparation for negotiations: Reliable analyses and tools to support decision-making will be provided.

• Better reimbursement terms: Mutual cooperation will be undertaken to formulate solutions that meet the client's expectations and present them in a manner that is appealing to the payer.