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Payer insights enable businesses to achieve strategic goals

Posted by Sam Mabaso | 05 April 2022
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Find out how some of our customers used the knowledge gained from payers to achieve strategic business goals.

 

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Payers provide unique insights on a range of business aims, including entering a new market, launching a new product, or understanding a treatment landscape. 

Discover how we connected various customers with payers, enabling them to achieve their strategic business goals.  

 

Payers and neurologists inform new market opportunity for pharmaceutical company 

A management consultancy assessing a new market opportunity for their pharmaceutical client needed to engage with payers and neurologists to help develop strategic recommendations for the end client's digital therapeutics products (DTx) – products that deliver evidence-based therapies via software directly to patients to prevent, manage, or treat a medical disorder or disease.  

The DTx products they were investigating centered on treating Parkinson’s disease (PD) and chronic pain with kinesiophobia – the fear of pain due to movement (CP-K).  

The customer needed to assess the market opportunity for these DTx products in the US, France, Germany and the UK by connecting with neurologists who treat patients with PD and CP-K, and payers responsible for coverage decisions in the specified geographies.  

We sourced the relevant experts and connected them with the customer, who used the insights to penetrate the US, France, Germany and UK markets with the two new PD and CP-K DTx treatments. 

The payers the customer engaged with included: 

  • A Pharmacy Director with over 20 years of experience as a payer and works for a regional plan which covers 700,000 lives to customers with commercial insurance. 
  • A Medical Director who has been in practice for over 22 years and is the department head at a health insurance company. 

 

Payers’ in-depth insights enable consultancy to better understand US overactive bladder treatment landscape 

A leading life sciences consultancy conducting market research for their end client needed to connect with senior payers (Medical Directors and Pharmacy Directors) to gain a more in-depth understanding of the overactive bladder (OAB) market landscape in the US. 

We facilitated qualitative interviews between the payers and the customer, allowing the customer to improve their knowledge of the current treatment landscape for OAB, reimbursement and utilization management for current therapies, payers’ approach to contracting with manufacturers for available therapies, and how future market events may impact reimbursement and utilization management. 

The customer gained insights from payers such as: 

  • A Medical Director with 16 years of experience in the market access/reimbursement industry, who has significant influence over formulary inclusion and reimbursement decisions. 
  • A Medical Director with 13 years of experience in the reimbursement field who works at a health plan covering over 30 million lives. 

 

Market research propelled by payers and physicians 

A healthcare strategy consultancy doing market research on behalf of a pharma company needed to connect with US-based movement disorder physicians and payers covering movement disorder drugs. The experts had to be well-versed in existing and pipeline therapies for disorders including, Parkinson’s disease, cervical dystonia, Huntington’s disease and multiple system atrophy. 

Using our AI, we found and connected the customer with the exact experts they asked for, enabling them to create and present various strategies to their pharma client. 

Some of the specialists the customer gained insights from were: 

  • A Medical Director at a health insurance company who oversees reimbursement decision-making for products covered under both medical and pharmacy benefit and is co-chair of the P&T committee. 
  • A Head of Business Development at a pharma research and drug discovery company with over 15 years of experience in licensing and M&A as an advisor and valuation specialist, whose recent experience is within the central nervous system space. 

 

Oncologists and payers shed light on Southeast Asia cancer treatment landscape 

A consultancy needed to understand the cancer treatment landscape in Southeast Asia to support a market research project they were doing for their end client. They asked us to source them oncologists based in Malaysia, Thailand and Vietnam experienced in treating patients with bladder cancer and payers well-versed in the evaluation, management and pricing of oncology medicines.  

The firm reached out to us as the vendor they were using was struggling to find them the oncologists and payers they were after. Fortunately, our AI search technology isn’t bound by geography or fixed databases. Instead, it analyzes billions of online data points to discover experts that other vendors can’t, which enabled this consultancy to get the expertise they needed. 

We connected the customers with payers including: 

  • A Head of Payer and Patient solutions with over 12 years of experience leading growth initiatives across product launches and the delivery of healthcare across its value chain, from R&D through to the commercialization, distribution and use. 
  • A Director of Pharmacy with a comprehensive understanding of the Vietnam pharmaceutical market, expertise in market entry, business process design and implementation. 

 

Biotechnology company’s product investigation informed by payers’ expertise 

A biotechnology company investigating the treatment of Rett syndrome asked us to connect them with US payers to gain a better understanding of the landscape for this rare condition. Rett syndrome is a genetic disorder that affects brain development and causes severe physical and mental disability from early childhood, mainly in girls.  

The payers needed to: 

  • Hold a senior position such as Pharmacy/Medical Director at a managed care organization. 
  • Cover 5+ million lives in their organization. 
  • Be part of the formulary decision process within their plan/organization. 
  • Be able to speak on how new products within neurology may be accessed and incorporated in their organization's formulary in the future. 

We found the payers matching the criteria above and facilitated qualitative interviews with the customer. The payers the customer engaged with included: 

  • A Pharmacy Director at a leading provider of health insurance covering 10+ million lives who has over 16 years of experience and is a voting member on formulary decisions. 
  • A Regional Medical Director at a prominent health plan provider covering five million lives, who is a consulting member on formulary decisions, and has 10 years of experience. 

 

Payers and endocrinologists assess opportunity for a new product in congenital adrenal hyperplasia  

Congenital adrenal hyperplasia (CAH) is a group of rare genetic disorders limiting hormone production in the adrenal glands, affecting a child's normal growth and development. 

A pharmaceutical company asked us to facilitate qualitative interviews with US-based payers and endocrinologists to assess the opportunity for a new product in CAH. 

The payers had to hold senior titles such as Pharmacy/Medical Director, be part of the formulary decision process within their organization and be able to illuminate on how new products within endocrinology may be accessed and incorporated into their organization's formulary in the future. 

The endocrinologists had to have been in clinical practice for five to 35 years, see more than five CAH patients a month and be able to speak at length about the potential use and utility of emerging therapeutic approaches for CAH. 

Our AI thrives on precision, ensuring we connected the customer with the exact experts they needed, including: 

  • A Pharmacy Director with over 20 years of experience as a payer and works for a regional plan which covers 700,000 lives to customers with commercial insurance.   
  • A Senior Medical Director at a large non-profit healthcare company and integrated delivery network that covers more than 10 million lives. 

 

Need insights from subject matter experts to inform your strategic decision-making? We can help! 

About the author

Sam Mabaso

Sam Mabaso is Associate Director of Marketing at techspert.io and leads the company’s marketing function. Sam holds a Master’s degree in Media Studies from the University of Cape Town and has more than 8 years of experience in marketing.

All posts by Sam Mabaso

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