Business Planning

Strategic eye to the future

Business Planning: A Strategic Eye to the Future

A comprehensive business planning strategy is critical for both payers and pharmaceutical manufacturers. A fresh look from a pharmaceutical consulting firm with a proven track record in pharmacy benefit management and rebate strategy may be just what your business plan needs. Enrollment in Medicare, Medicaid and the new Healthcare Exchanges is expected to grow significantly. Our team has successfully helped both payers and pharmaceutical manufacturers navigate through all of the major changes in health care for over two decades. In recent years, our team drove one of the most successful and responsive Medicare plans in the marketplace. We will use our experience to help you find unique solutions to future events that will most impact your business.

Pharmaceutical and biotech manufacturers:

• Higher control Medicare and Medicaid plan designs
• Increase in consumer driven health plans and deductible plans will put more burden on the beneficiary to be cost conscious
• Decreased payer access and consolidation
• Generic only, closed formularies in categories with multiple generics
• Tiered copay or percentage copays when brands are needed
• Majority of drug spend effectively managed by generics resulting in few brands remaining covered
• Pipeline analyze, understanding the impact from the most likely competitors
• Commercialization strategies for new innovative products that may offset medical expenses
• Pipeline and competitive analysis for specialty and biosimilar markets
• Design strategies for HEOR and cost effectiveness studies for best payers access

Health insurers and other payers:

• Balancing high control with adequate beneficiary access and minimized administrative costs
• Adherence and compliance support with high deductibles and cost share
• In categories with multiple brands, ensuring the right partner evaluating both quality and cost
• New generics in 2016-2020 predicting net cost after copay
• Pipeline analysis to understand future projection (cannibalize current or represent new drug spend)
• Planning for innovative new categories that may offset medical expenses
• Plan design strategies and cost projections for specialty and biosimilar markets
• Evaluation of HEOR and cost effectiveness data to determine best quality and cost balance