Reimbursement Strategies Workshop

Reimbursement Strategies Workshop

The biotech and pharmaceutical industry has been changing rapidly over the last decade, with market access and reimbursement strategy and planning assuming a greater role in ensuring commercial success. Novel and complex regenerative therapies currently under development representing new modes of treatment will be faced with even greater challenges in navigating the reimbursement and economic landscape likely to impact their launch.

The reimbursement strategies workshop will provide an overview of the current reimbursement landscape, primarily in the U.S., but also touching on other markets as well. Attendees will learn of different frameworks to analyze the reimbursement landscape their products will face and how the analysis may be used to inform the product value proposition for different stakeholders. Attendees will benefit from an exploration of the following questions:

Key Questions That This Workshop Will Address:
• Who are the important stakeholders that will impact commercial success of my product portfolio?
• What are the current trends in payers’ utilization management and coverage policies for high cost therapies?
• How do I best position my product to healthcare insurance providers, both public and commercial payers?
• What are the main considerations of the type of benefit design(s) that will reimburse my product?
• How do provider payments vary by setting of care, and what challenges are inherent within each setting of care?

o How do the payment differences influence access to our products?
o What will be the impact of the recent shift towards value based and integrated healthcare payment systems on our market access approach?
o What are the current barriers to alternative payment models such as fixed payment or periodic payment for gene therapies?

• How do I build my commercial framework to help optimize patient access and gross to net?

o Which factors will most affect our gross to net calculations and how should we verify whether discounts or other pricing strategies will impact our pricing in other channels?
o What are the key patient support considerations to mitigate potentially prohibitive patient out of pocket barriers?

Roshawn Blunt, Managing Director, 1798 Consultants
Mary Roberts, VP, 1798 Consultants

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