This renowned global manufacturer engaged Numerof to develop a disciplined approach to integrating value and market access considerations into key product development and commercialization decisions. By reshaping roles, processes, and organizational structure, our work transformed reimbursement and health economics functions to support a diversified, value-driven product portfolio.

Situation

• A renowned global manufacturer faced global reimbursement and pricing pressures. Prior efforts to address these challenges had been siloed and not systematic.
• Seeking to transition from cost-plus pricing to value-based pricing, the client engaged Numerof to develop a more robust and disciplined approach to integrating value and market access considerations into key product development, portfolio management, and commercialization decisions throughout the life cycle.
• Additionally, recognizing that successful implementation of this strategy required new, sustainable infrastructure, the client asked Numerof for help making the necessary changes to organizational structure, roles, and processes to achieve their goals.

Intervention

• Numerof assessed existing reimbursement-related analysis and decision-making efforts, taking broader portfolio and strategic contexts into consideration.
• We designed integrated processes for efficiently gathering and appropriately evaluating market access related information to inform product development and strategy efforts. The new approach called for the reimbursement and health economics functions to become more involved in early planning and decision making, guide evidence collection, set aggressive reimbursement outcome goals, and be held accountable for them.
• To support implementation, Numerof defined needed changes to organizational structure and utilized a job charter methodology to clarify the strategic importance, accountabilities, required competencies, and authority of key roles. We also developed a resource algorithm to guide and justify staffing levels.
• In order to link the new processes and structure to the external environment, Numerof produced studies on epidemiological trends for highly prevalent and costly medical conditions related to the company’s products in the US and other global markets. We also provided guidance on the kinds of clinical and economic evidence required by payers and implications for commercialization.

Impact

• Numerof’s work increased the accuracy of financial modeling, projected payer responses, and sales projections. In turn, it also enhanced go/no-go decisions, product pricing, and market entry timing.
• The new infrastructure promoted earlier identification of breakthrough technologies and new product platforms, helping the client efficiently build differentiated product and market portfolios that support premium pricing and profitability.
• Our market analyses identified key opportunities to redefine product value and justify reimbursement based on reducing the total cost of care. The client built its business plans around our findings and recommendations, and continues to be a market leader.