Value-Based Strategies for Reimbursement & Formulary Success – Value-Based Strategies for Reimbursement & Formulary Success

Today’s sweeping systemic healthcare changes overwhelms the entire life science and healthcare industries. Access is getting tighter, while prices are increasing and manufactures are stumbling to get and/or keep their drugs on formulary. A drug’s success is not only achieved in its clinical trial, but also in its ability to gain formulary access on the insurance plans with the most lives.

Regulatory, commercial, R&D, and market access teams within organizations are challenged to collaboratively develop a narrative of the drug that proves its efficacy through clinical, regulatory, and commercial bench markers. Once a drug gains FDA approval, pharma still has a significant journey to go. Payers who already have a comparable and less expensive generic brand on their formulary typically reject brand-name products. Pharma is then faced with developing innovative strategies to get its product in front of patients, utilize the rendering real-world evidence, and then return to the payer with greater proof of the drug’s efficacy and increased value to again request formulary access.

ExL’s first annual Value-Based Strategies for Reimbursement and Formulary Success pioneers the conversation of the transition from price-centric to value-based formularies. Life science and healthcare insurance executives will provide attendees with education in proving value, instead of managing pricing of drugs coming onto the market. This event will arm professionals with the skills and methods to prepare for formulary success before FDA approval through regulatory, medical affairs, R&D, and market access collaboration. The event will also provide strategies for those who do not gain formulary access initially, so that attendees walk away with an auxiliary strategy to ultimately gain formulary approval through post-approval market access expansion tactics using real-world evidence and HEOR.

Top Five Reasons to Attend

  1. Learn how to navigate the future of healthcare reimbursement given today’s healthcare climate
  2. Identify proactive strategies that expand patient access in an era of increasing cost controls and utilization management
  3. Define the data and metrics per therapeutic type necessary to prove a product’s value
  4. Explore how to use real-world evidence to verify a drug’s increased value post-approval
  5. Illustrate strategies to prove that a drug is not only valuable for its therapeutic outcomes, but for overall decreases in healthcare costs as well

Who Should Attend

This conference is designed for representatives at healthcare insurance, biopharmaceutical, medical device, and formulary organizations with the following responsibilities:

  • Formulary Management/Operations
  • Reimbursement
  • Health Economics & Outcomes Research
  • Access
  • Contracts
  • Pricing
  • Managed Markets
  • Payer Strategy
  • National Accounts
  • Managed Care
  • Indication-Specific Pricing
  • Patient-Center Outcomes

This conference is also of interest to:

  • HEOR/Real-World Evidence Solutions
  • Pricing, Contracting & Market Access Vendors
  • Reimbursement Solutions
  • Formulary Access Vendors