payer relationships

According to the American Hospital Association, hospitals nationwide remain liable for up to $41.1 billion in unpaid healthcare costs annually.  This cost is up from the recorded amount of outstanding costs in 2010 ($39.3 billion).  Currently, Jack Hadley, senior...

Before prospective pharma products are even knee-deep into development, new product planning teams are tasked to start thinking about their commercialization. Tightening payer budgets and shifting reimbursement requirements are forcing teams to emphasize the value...

In this harsh reimbursement environment, payers are looking beyond a drug’s efficacy and to its cost-effectiveness when approving drugs for their formularies.  To adapt to new payer demands, pharma companies are incorporating health economics and outcomes research...

Significant changes to medical science liaisons’ roles and expectations in the past 15 years have underscored the value MSLs bring to their organizations. MSLs not only provide access to highly influential physicians and medical researchers, but they also bring...

Before US managed markets teams approach payers, they need to understand the different payer groups. All groups — Medicare and Medicaid, insurance companies, specialty pharmacies, hospitals, etc. — share the same fundamental function: to sift through the many...

As payer relationships become more important than ever, many companies are working hard to build and support teams that can communicate pharmacoeconomic benefits to payers. The members on these teams, often called outcomes liaisons or health outcomes liaisons (HOLs),...

By Michelle Vitko, Senior Research Analyst When companies first approach payer organizations with information about a new product, it is important that managed markets account managers convey why payers need their product. Account managers must have...

By Michelle Vitko, Senior Research Analyst Preparing to present data to managed care stakeholders is often health outcomes liaisons' (HOLs) most time-intensive activity. While the exact breakdown of time investment varies from company to company, most...

By Shaylyn Pike, Senior Research Analyst The managed markets function in the United States has been around for many years. Since the arrival of Medicare, Medicaid and the health insurance industry in its current form, drug and device companies have...

By Shaylyn Pike,Senior Research Analyst Once upon a time, a brand team's quest ended at marketing approval; revenues would take care of themselves. Fast forward 20 years, and the industry faces a much more challenging road to brand success. Receiving...