Payer Access & Reimbursement
Stay Ahead in an Evolving Payer Landscape
Payers are tightening formularies, increasing utilization management barriers, and leveraging sophisticated partners to inform management strategies, making market access more complex than ever. The Dedham Group is your strategic partner in overcoming these challenges, offering deep expertise in optimizing payer strategy, understanding vertical integration and partnership influences, and in evaluating coding and reimbursement impact. We help manufacturers identify access risks, anticipate reimbursement and coding challenges, and develop target strategies to engage payers and optimize coverage. Our proven approach ensures manufacturers are prepared with both pre-, at-, and post-launch strategies to navigate evolving payer requirements, secure appropriate steps to reimbursement, and ultimately, reach the patients who need therapies the most. With deep industry insight and strong payer relationships, The Dedham Group equips you with the tools and strategies needed to stay ahead in a dynamic market.
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Our Tailored Services for Success
Evaluate competitive therapeutic area landscape access dynamics, management drivers & priorities, and access threats and priorities.
Assess emerging management trends & landscape dynamics, UM tactics, precedent & implementation and determine the extent of pull-through success.
Leverage TPP materials to determine anticipated management & review considerations & potential access & adoption risks.
Pressure test branded agent’s unique value (competitive and differentiated) via value proposition testing to refine payer channel materials.
Determine holistic management pressures (vertical integration, PA development, MBMs/OBMs) & access implications and opportunities.
Proactive research on competitor launch value & brand differentiation strategy to mitigate threats and optimize access.
Evaluate LBM & MBM ecosystem entities & stakeholder relationship influence mapping, preferred lab networks & impact on access, and in-depth CDx & Dx management analysis.
Develop in-depth access & monitoring tool to support, track, payer coverage with indication specific management per books of business.
Ongoing monitoring of brand & competitor value perceptions & challenges per clinical, operational, and economic triggers.
We Provide:
Dedicated Influencer Panel
The Dedham Group’s expert panel delivers ongoing insights into emerging access challenges and value drivers, equipping you with local-level, data-driven intelligence to optimize engagement and partnerships.
Value & Access Expertise
Rich Data Analytics
Additional Resource:
Solving Access Barriers in Biomarker Testing: 5 Tips for Manufacturers
The authors discuss the access barriers facing patients who need biomarker testing. They discuss five ways manufacturers can prevent these barriers from affecting patients. Read on for their insights.
Understanding Access Barriers in 2024 and Beyond
Navigating the landscape of patient access in the pharma industry has become increasingly complex, extending far beyond traditional channels. The challenges are multifaceted, influenced by evolving policies, innovative payer strategies, and shifts in provider dynamics.
