Place header for sub dropdown here

Place sub header for sub dropdown here

Subscribe to Our Blog

Contracting Decisions and Access Optimization

By  Paragon Solutions Paragon Solutions  on 2013-07-03 06:30:26  |  Featured in  Life Sciences
Paragon Solutions
Posted By Paragon Solutions
in Life Sciences
on 2013-07-03 06:30:26

Competing On Analytics……

Life Sciences Managed Market and Contracting organizations are challenged to partner effectively with Payers (private and government) and derive a positive healthcare and economic outcome.

Over the past decade, the overall rising cost of healthcare and saturated markets has given way to sophisticated formulary protocols. Since 1995 the shift of leverage away from manufactures to Payers has and will continue to rise.

The good news is that better information across clinical outcomes, payer economics, prescribers, patient access, company data bases, government and third parties has made is possible to understand and partner with Payers thus making medicine available at the right price.

So where is your organization? Just thinking, making progress or has advanced capabilities that generate significant competitive results. If you are just thinking about enhancing your Managed Markets information and decision making tools you are not alone. Eighty percent of Life Science companies wish they were more proactive and efficient with respect to:

  • Understanding Formulary and Access
  • Negotiating win-win pricing and reimbursement terms
  • Monitoring and Informing Outcome
  • Pulling Messaging through to Prescribers

To complete the full investment cycle, excellence is required in all of the above. Achieving commercial excellence is dependent on not having a weak link. If one of the capabilities is not in place expect that you will either not know or know too late that a rebate investment was not productive.

Do You Manage a Portfolio?

Yes but not just your personal equities. The company you work for has entrusted your team to manage the relationship with payers and the availability of medicine to patients. More and more CEOs and CFOs mandate that pricing fall under the same rigor as other investments they consider on a daily basis. And if it has not come down via a large management consulting recommendation it will, soon.

Understanding the true value of payers, capturing decision artifacts and plotting ROI is a key to being proactive and informing key stakeholders across your organization.

A Peak, Once Not Attainable is now a Walk in the Park

Evolution in the Managed Markets and Contracting decision making area has progressed. If you track back to where and who made the break through to completing the picture one does not need to go far. Companies with significant portfolio risks and major products loosing exclusivity have produced some of the most sophisticated and intelligent decision making capabilities, some comparing to a Wall Street Portfolio.

Portfolio life cycle has a direct correlation to capabilities. Most early stage portfolios where sales are growing steadily actually have little market intelligence when it comes to Payers and Contracting. These companies are prime candidates to start thinking long term and make the investment, early, to make available best in class decision making tools and analytics and achieve commercial excellence throughout a brands life cycle.

Why Do Most Companies Not Work To Complete The Picture?

Inexperience, if you have not been in the frying pan of a dying portfolio and experienced the need to count pennies on diminishing revenues the challenge to put all the pieces together gets a second priority. Remember the companies that did ride the wave to L.O.E., well the roadmap is there.

It is now very possible to fill in the gaps in contracting and third party information, develop best practices for determining Net Sales Pact, Rebate Forecasting, Customer Valuation and the pinnacle of understanding ROI and support decision making around Account Planning, Optimal Pricing/Contracting and effective Pull Through to Prescribers. As well as being the conduit for informing other areas of a Life Sciences organization.

Setting Goals for 2013 into 2014

If it is not on your radar or even a line item in your budget then please consider raising the bar. Still somewhat skeptical? Then classify optimizing contracting, tracking outcome, informing stakeholders and deriving true ROI as stretch goals. Completing the picture for the “C” level investors was once an art is now a mandate. Set your goals high in 2014.

View Comments