Case Simulation

A large biopharmaceutical company was preparing for the launch of a MM unique brand in Lebanon.

Although the new brand is innovative, the client expects that there will be a challenge for reimbursement due to the brand high price. Since the price is preset due to reference countries, the client decides to include in his value dossier a Managed Entry Agreement proposal, which will help payers manage their budget and sensitize them to negotiate he brand introduction on formulary.

CCHO has been solicited by the company to help them design, negotiate, and implement the best MEA which will optimize brand chances for reimbursement.

Tactics:

A combined methodology approach utilizing in-house market access expertise to undertake the following:

  • Stakeholder mapping: Key market access stakeholders at national and regional level.
  • Overall Reimbursement route for MM drugs

Reimbursement decision analysis:

Analyze decisions i.e. drivers and barriers in Reimbursement.

Expert Interviews and Focus group:

Perform detailed interviews with payers and clinical experts to isolate opportunities and barriers relevant to the client.

Actual cost, population size, and treatment pathway, to adapt/design a budget impact modeling and impact analysis of the new brand introduction on payer.

Key Deliverables:

  • A report including key payers decision and value drivers.
  • Budget Impact Analysis of the new brand introduction on payer.
  • Strategic recommendation surrounding who to target, dossier content, evidence needed, and tactics including Managed Entry Programs/RSS/PAP.

Implementation part:

Data generation and design of MEA/RSS/PAP programs using modeling outcome to be appealing and communicated with payers.