Reimbursment Models

Based upon the past and the current state of affairs in healthcare, healthcare reimbursement will change dramatically in the future.

Generating relevant economic and humanistic evidence for a variety of different stakeholders, health authorities and technology assessment agencies requires a multidisciplinary approach to the design, execution, and analysis of data.

Key Questions:

•  Do I need an assessment of the effectiveness and cost of my product for reimbursement purposes?
•  Am I interested in assessing the impact on health service budgets following the implementation of my product?
•  Do I require independent, evidence-based scientific advice and research support for market access?
•  What might the future look like for healthcare reimbursement?
•  How will the perceived value in the marketplace translate into willingness to pay and ultimately a company’s ability to capture the value of their investment?
•  How should price be managed in the context of new market entrants, new indications or new attributes?

With an established network of thought leaders, academic affiliations, and payers, MRA Group develops customized solutions to challenges and opportunities at the global, regional, national, and if required, sub-national levels.

How We Help?

•  Comprehensive analyses and solutions
•  Interdisciplinary approaches, including health economics and modeling, epidemiology, psychology, statistics, clinical medicine and information technology
•  Information on decision-making processes and requirements within health systems
•  Experience in planning structures and processes in health care systems
•  Health economics analyses (cost-minimization, cost-effectiveness, cost-utility and cost-benefit analyses)
•  Budget impact analyses
•  Support in pricing and reimbursement
•  Review/analysis of health economics data (costs and outcomes)

MRA Group is uniquely positioned to translate robust evidence into insightful and actionable pricing, reimbursement and access strategies that support commercial success.

At MRA Group, we recognize that multiple decision-makers can create complex pricing challenges. We will leverage our in-depth knowledge of the pricing and reimbursement structures of global markets and the varying objectives of key stakeholders to optimize your pricing. We believe there is no universal pricing research technique and will employ customized analytics and consulting to address your needs - from early-stage identification of value drivers to final product launch pricing.

Analysis Involved:

•  Reimbursement Value Analysis: The way in which the reimbursement value of your pharmaceutical product is determined, proven, and communicated is essential to generating success in the marketplace. The results of a reimbursement value analysis will have serious implications on your pharmaceutical product clinical and market development. There are three main aspects to reimbursement value analysis:
      1. Setting The Right Price
      2. Conducting The Right Studies
      3. Sending The Right Message
•  Payer Market Analysis: There are multiple aspects about the payer market that need to be understood to successfully launch and sustain a place within the pharmaceutical market. You need to know the payers who are already receptive to your product and those who need further payer education. We will profile and segment the relevant payers for you by examining their medical policies which are applicable to your product. With this knowledge, you can target appropriate actions for each payer segment and, if needed, identify additional data requirements for building payer acceptance
•  Economic Analysis: An economic analysis can provide the financial information today's payers want to know in terms of the comparative cost effectiveness of treatment methods using different pharmaceutical products in relation to current standard-of-care methods.
•  Payer-Mix Analysis: Determining the dominate payers for specific disease states is important to pharmaceutical drug manufactures. Knowing which types of payers from the payer-mix will dominate your product's market enables you to choose education and advocacy methods targeted specifically to them. The right combination of clinical, regulatory, and contract expertise will vary by payer. We will equip you with the right blend of expertise for the payer-mix within your marketplace.

Business Impact:

•  Impartial advice and support concerning reimbursement processes from an independent scientific organization
•  Application of a wide range of scientific methods and designs
•  Pricing strategies that ensure the full benefit of opportunity in price sensitivity and receptivity to reimbursement solutions that creatively address payer needs
•  Market access strategy development and execution to achieve optimal conditions based on local, regional and global policies, dynamics, and drivers
•  Unparalleled stakeholder reach, including access to payers, physicians, patients, pharmacists and other purchasers
•  Methodologies to suit all needs from the simple to complex situations (e.g., integrated multi stakeholder linked-choice models that are unique in that they focus on real-world interaction and influence)

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