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Workshop B • Hone Your Reimbursement Strategy to Ensure Favorable Coverage, Coding and Payment Decisions based on Clinical and Health Economic Evidence

Workshop objective:

Product launch success requires understanding and carefully navigating today’s changing clinical, legislative and reimbursement landscape. This workshop examines key components of a reimbursement strategy that can optimize market commercialization of products.  Discuss best practices honed from experience with hundreds of product engagements.  Areas addressed include market research, value and message testing as well as environmental, reimbursement and pricing assessments.

Key Questions to be addressed:
•    What are some decision points and drivers for reimbursement design and development?
•    How do you conduct effective primary and secondary research as part of a reimbursement strategy?
•    What are the steps to execute a reimbursement strategy post-launch

Workshop Outline:

I.    Market Assessment and Strategic Research
•    Understand market and economic dynamics
•    Identify access obstacles and opportunities
•    Conduct primary research with payers, providers, P&T committee members and other key stakeholders
     *    phone and in-person interviews, site visits, advisory boards and web-based research
•    Perform secondary research examining current coverage policies, coding precedents, payment scenarios and payer mixes

II.    Strategy Development — Decision Points and Drivers for Reimbursement Design and Development
•    Coverage, coding and payment
•    Payer profiling and targeting
•    Market preparation — Awareness and access to the product
•    Patient demographics
•    Education and awareness — Provider education and sales force training
•    Infrastructure planning
•    Evidence development

III.    Reimbursement Execution — Post-Launch Strategies and Development
•    Payer utilization controls and payment policies — Payer profiling and targeting, payer presentations and AMCP dossiers
•    Produce meaningful, actionable data and results — Coverage policy tracking and analysis
•    Provider reimbursement training — Billing and coding guides, reimbursement forms/coding applications
•    Payer engagement strategies
•    Reimbursement services — Hotlines, integrated HUB solutions, comprehensive case management and patient assistance programs

There will be a 30-minute networking and refreshment break at 10:00 a.m.

Stephen Chan
Director of Strategic Consulting Services, Reimbursement & Access Services
McKesson Specialty Health
Heather Morel
Vice President, General Manager, Reimbursement & Access Services
McKesson Specialty Health
Rahul Dhanda
Director, Health Economics Outcomes Research
McKesson Specialty Health