SOURCE: Cutting Edge Information

Cutting Edge Information

November 03, 2015 11:35 ET

64% of Life Sciences Companies Utilize a Centralized Team to Handle US Government Reimbursement Activities

Large Drug Companies, However, Tend to Decentralize Government Reimbursement Teams, According to Cutting Edge Information

RESEARCH TRIANGLE PARK, NC--(Marketwired - November 03, 2015) - A recent study found that 64 percent of surveyed pharmaceutical and medical device companies employ a centralized team to handle government reimbursement activities. Larger companies, however, are more likely to segment their reimbursement teams, according to pharmaceutical intelligence firm Cutting Edge Information.

Life science companies organize their US government reimbursement teams in a number of ways. Structural differences may vary according to company needs, resources and preferences, but are largely due to the resources available to a company. The benchmarking study, "US Government Drug Reimbursement," outlines the organizational structures for life sciences companies' managed care reimbursement teams.

All surveyed small companies centralize their reimbursement teams -- likely because they do not have the resources or expertise to specialize. Similarly, companies that heavily depend on government reimbursement may have large teams in which each person is subspecialized for a particular activity, such as calculating average sales price (ASP). They may also have dedicated contracts and pricing committees to determine drug discounts for different consumer markets. These specialized teams help large companies identify and reach their reimbursement goals faster and more efficiently.

"While the majority of companies utilize one team for government drug reimbursement, large companies with more available resources may choose to decentralize these operations by therapeutic area, brand or development phase," said Jacob Presson, senior research analyst at Cutting Edge Information. "These structures may enhance the company's government reimbursement operations."

According to Cutting Edge Information's study, only 33% of surveyed Top 50 companies have a centralized team. Instead, 17% of Top 50 companies surveyed assign responsibilities either by lifecycle stage, brand, therapeutic area or a combination of these structures. Small companies, on the other hand, may not have the resources to segment government reimbursement teams, which may be why 100% of surveyed small teams centralize their groups.

"US Government Drug Reimbursement: Winning Key Formulary Positions and Managing Pricing Systems," is available at http://www.cuttingedgeinfo.com/research/market-access/us-government-drug-reimbursement/ and provides a road map for better navigating government drug reimbursement in the United States amid the growing influence of the Affordable Care Act. The report, derived from primary resources and direct interviews, focuses exclusively on US government reimbursement strategies and trends, draws on quantitative and qualitative data from top-performing life science executives to provide actionable insights for winning and maintaining formulary position. Additional guidance outlined in the report includes:

  • Anticipating government payer needs and developing strong market access strategies
  • Managing payer relationships before and after product launches to maintain formulary position
  • Understanding compliant government reimbursement practices in the United States' new healthcare environment

To learn more about Cutting Edge Information and its research report offerings, please visit http://cuttingedgeinfo.com/.

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