Posted by: Audrey Erbes | September 21, 2014

Product Reimbursement and Pricing: Viewing Relevant Factors Systemically Plus Events and Jobs

The world of life science pricing is being turned on its head as the various sectors struggle to achieve a valuation for their new product that is “just right”—that which achieves profitability for investment but that still enables reimbursement by payers. I just heard one of the best talks ever on reimbursement by Jessica Holmes, Director of Reimbursement Argenta Advisors, at this past week’s Bio2Device Group meeting. Jessica provided a systems approach to reimbursement in Medtech which also applies equally to pharmaceuticals. Instead of looking at just one part of reimbursement she looked at how the overall healthcare system, payers, physicians, and other stakeholders struggle to find ways to reimburse the best value-based care products and keep within bounds of financial constraints by taking a look at how all the environmental factors interplay with each other.

Health care systems merge as it becomes more difficult for small organizations to meet demands of more efficient, improved medical care for large numbers of patients with value-based pricing. Company forecasters will find their task becomes even more difficult to project income let alone viable pricing for their new products.

I checked into progress at Real Endpoints to provide (1) solutions to payers for select products for reimbursement and (2) useful market intelligence to manufacturers to handle their needs to price correctly. I share with you the business tools provided by RE via their Reimbursement Intelligence products. Pricing and reimbursement are very complex and RI provides the information needed to track the various factors that need to be explored. See recent blogs which discuss the issues in pharma pricing and reimbursement.

The recent announcement of Gilead regarding the licensing of Sovaldi to 7 generic companies in India to develop and manufacture product for 91 countries outside the U.S. reinforces the burden of pricing for innovative drugs for so many patients who are infected.  I wonder how long it will take for American health care systems to provide paid vacations for their covered patients to travel to these sourced countries for treatment at huge saving to U.S. provider. This will surely provide a big boost for medical tourism. Perhaps that’s why Mexico is not one of the covered countries—too easy to cross border for low priced treatment.

Highlights of This Coming Week’s Events

  • BioCentury This Week, See new program Webcast Starting Sunday, Sept. 21, 2014,, Available anytime starting at 9:00 a.m. EDT; Topic: “Room to Run: Prices, Stocks, and NIH;” Speakers: Steve Usdin, Washington Editor, BioCentury; Erin McCallister, Senior Editor, BioCentury and Eric Pierce, Publisher, BioCentury
  • Bio2Device Group, Tuesday Morning, Sept. 23, 2014; Topic: “Leveraging Wearable Technology to Monitor Chronic Health Conditions, Speaker: Anoo Nathan, CEO, Smart Monitor
  • Janssen Labs, Tuesday, Sept. 23, 2014, Topic: “Digital Diagnosis – Harnessing Digital Technology to Improve Personal Health,” Panelists: Rick Beberman, Digital Health and Health IT Investment and Corporate Development Professional; Daniel Kraft, MD, Physician / Scientist at Stanford Medical School, Faculty & Medicine Track Chair for Singularity University; Ashwin Ram, Area Manager & Chief Innovation Officer, Interactive Intelligence, PARC, a Xerox Company ; Nirav Sheth, Director of Market Development, Medical, MC10 Inc. ; Casper de Clercq, Partner, Norwest Venture Partners. moderator
  • MIT Club of Northern California, Tuesday Evening, Sept. 23, 2014, Topic: “Can Big Data Cure Cancer?” Speaker: Dr. Marty Tenenbaum, Cancer Commons
  • BioScience Forum, Wednesday Evening, September 24th, 2014, Title: “Anti-Cancer Agents Targeting Protein Homeostasis: A Novel Approach using p97 Inhibitors,” Speaker: Mark Rolfe, Ph.D., President and Chief Scientific Officer, Cleave Biosciences Inc.

You can download Audrey’s Picks with complete details on the above and other meetings and conferences through Dec. by right clicking on Audreys Picks Sept.21, 2014. Also see JobsThatCrossedMyDeskThrough Sept. 21, 2014with same method.



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