Understanding Payer Dynamics. A critical factor in maximizing brand performance. Healthcare Measurement IMS Payer Insights

Transcription

1 Understanding Payer Dynamics A critical factor in maximizing brand performance Healthcare Measurement IMS Payer Insights

2 Understanding Payer Dynamics A critical factor in maximizing brand performance In an environment where only half of new products are recommended for formulary listing, where listing across Canada s provinces is uneven and inconsistent, and where competition differs in the public payer space from the private payer space, the imperative to monitor and track product performance by payer becomes paramount. Payer-level insights facilitate a company s ability to capture a product s full potential throughout its lifecycle. With an extensive assortment of valuable payer-level insights, IMS Brogan provides the visibility you need to accurately identify the sources and understand the interplay of privately and publicly-paid medications to help you exploit untapped potential, maximize brand performance, or understand the complexity of multi-payer markets. Over the last two decades, we have been designing solutions around complex client requirements and have delivered thousands of quality reports to help our clients examine and understand contemporary market situations to support payer market specific strategies and succeed in the marketplace. We offer a broad spectrum of payer perspectives that will empower you in meeting your Sales, Marketing or Market Access objectives, whether you need payer visibility to Source of Business, Dynamic, or Volume metrics. And only IMS Brogan can seamlessly link payer-level metrics to your existing performance measures so you can fill important knowledge gaps across your commercial applications. PATIENT-LEVEL PRESCRIPTION-LEVEL LRx BY PAYER Marketing, Brand Management and Market Access Solutions Rx DYNAMICS Rx TICKER PHARMASTAT PHARMASTAT PLUS Provincial Insights Source of Business Provincial Insights Market View Sales Force Effectiveness Solutions XPONENT NBRx BY PAYER XPONENT TRx BY PAYER Physician Insights GPM NBRx BY PAYER GPM TRx BY PAYER Territory Insights BY INFUSING A PAYER PERSPECTIVE INTO MANY CORE MARKETING, MARKET ACCESS AND SALES ACTIVITIES, YOU LL MAKE MORE INFORMED, EVIDENCE-BASED DECISIONS THAT OPTIMIZE COMMERCIAL EXECUTION. Understanding Payer Dynamics 2

3 Marketing, Brand and Market Access Solutions With Patient by Payer insights in our gold-standard databases, Marketers have another source of information that allows benchmarking, more accurate market sizing, and a deeper understanding of payer interactions across provincial idiosyncrasies. These benefits are available with our existing and new enhanced offerings tracking Source of Business, Dynamic, and Volume splits by Payer. IMS Brogan payer-level insights provide the benefits and flexibility of both claims data and pharmacy data in helping you understand source of business metrics, both within and across payers, to facilitate strategic and tactical decisions for new product launches, formulary listings, growth, through to loss of exclusivity. Provincial Insights - Source of Business LRx BY PAYER LRx by Payer provides de-identified patient-level Prescription Source of Business (New, Add-on, Switch, Repeat) insights to allow a better understanding of patient transitions. LRx by Payer empowers Marketers with yet another source of pharmacy-sourced information for benchmarking, more precise market sizing, and deeper understanding of payer interactions across all provincial idiosyncrasies. Leveraging this information allows the development of marketing programs or market access strategies aimed at enhancing brand performance. Monitor brand performance by patient and payer segment accurately Develop programs or market access strategies, monitor and track the impact of those programs What lift can I expect when I get formulary coverage in a new province? How do I characterize patients based on the type of coverage they have access to? How do I quantify patients who stop or switch medications when transitioning from private to public payers? Who is paying for our drug now that formulary access has changed? 4,000 3,500 3,000 2,500 2,000 1,500 1, Over 40% of this product s Rxs boosted its share of the private market prior to formulary listing as a result private share drops after listing Month 1 Month 4 Month 7 Month 10 Month 13 Month 16 Non-Public < 65 Non-Public 65 + Public 65 + Public < 65 LISTING TRANSITIONS FROM PRIVATE TO PUBLIC PAYERS - UNIQUE PAYER PROFILES BY PROVINCIAL FORMULARY Understanding Payer Dynamics 3

4 RxDYNAMICS With an extensive database of claims-based de-identified longitudinal patient drug utilization data, together with expert knowledge of drug plans own administrative datasets, IMS Brogan can bring valuable insights into the dynamics of payer markets through its Rx Dynamics reports. Designed to deliver market-specific insights at a granular level, Rx Dynamics depicts patient drug use patterns, prescribing choices, payer types, and dynamics of band competition to demonstrate the true source of your business to formulate effective promotional strategies within each payer market. Examine a broad set of key performance factors for your product and its competitors at the provincial level Identify patient drug use patterns and prescribing choices by payer type Develop more effective promotional strategies Pinpoint the true source of your business by payer segment on a monthly basis Who is paying for my product s prescriptions? What percent of diagnosed patients are covered by private plans? What categories of patients are more likely to claim our product in a selected province? Rx TICKER Rx Ticker allows you to quickly spot trends in payer markets as they develop. Sensitive to the slightest change in the competitive environment, it offers insight into physician prescribing patterns, product or program success and reveals potential market opportunities essential to making sound business decisions during critical stages of your product lifecycle: product launch, regulatory environment changes, and emerging competitive activities within payer markets. Rx Ticker provides a weekly view of patient claims volume by payer, within the payer markets, delivered via an online dashboard. It provides actionable intelligence that is a key to making sound business decisions during the critical stages of a product s lifecycle. Evaluate your product s payer dynamics within the ODB (Ontario Drug Benefit) and PDP (Private Drug Plans) markets Monitor new business vs. total business on a weekly basis for your brand and competitors Quickly quantify product or program success or risks following special events, as quickly as three business days after the week s end Who is paying for our product based on new formulary coverage? How quickly is our product gaining traction? How is market share changing following product launch? How many new patients are initiated immediately following launch? Understanding Payer Dynamics 4

5 Provincial Insights - Market View PHARMASTAT / PHARMASTAT PLUS PharmaStat provides administrative data reporting on the actual reimbursement activity of provincial and private drug plans for valuable insights into dynamics of the payer market. PharmaStat provides unprojected claims volume by payer type and reports on the actual payment activity of public and private drug plans as adjudicated. Reimbursement activities of each provincial drug plan is reported at DIN (Drug Identification Number) and includes the number of claims, cost, and the total number of units by province for each reporting period. PharmaStat Plus is an add-on module to PharmaStat that helps subscribers more accurately delineate the total prescription business using projected claims volume by payer type (Public, Private Direct, and Cash) for subscribed class of drugs. It provides a total view of the payer market. Understand the size of the public and private market segments as part of brand strategy Size market and benchmark performance Track formulary reimbursement trends to adjust strategies Understand which segments are driving performance, and where untapped potential or opportunities lie Monitor market share changes Detect trends as they develop Use in market access applications: Budget impact analysis, submissions, provincial listing agreements Pipeline analyses How is our product performing? Are there any market opportunities? Are there any changes in drug plan activities? Which payer market is driving my sales (public, private, cash split)? QUICK AND EASY TRACKING OF PRODUCT GROWTH BY PAYER WITHIN A MARKET HELPS YOU UNDERSTAND THE IMPACT OF NEW STRATEGIES Understanding Payer Dynamics 5

6 Sales Force Effectiveness Solutions A holistic approach to sales force effectiveness requires that sales professionals have access to insights that will enhance their efficiency in an increasingly dynamic reimbursement environment. More granular and actionable customer insights are available in both Xponent and GPM solutions including national payer splits (cash, private, and public) across all prescription volumes and dynamic patient-level volumes. This expanded visibility provides insights that are not only relevant, but consistent with the information you currently use to evaluate performance and compensate your sales force. Physician Insights XPONENT NBRx BY PAYER For sales analysis, distinguishing between public and private dynamic activity (NBRx) at the patient level can lead to differentiated prescriber insights and the ability to focus on appropriate, timely, and relevant messaging. Our consulting services can provide the ability and foresight to: Differentiate high dynamic prescribers (NBRx) by their patients access to private, public, or mixed reimbursement Focus on specific reimbursement segments and / or differentiate messaging in each segment Expand sales efforts to physicians whose patients have access to reimbursement Re-tune and refine existing physician segmentations to help realize a successful product launch Who is paying for the prescriptions written for our product since launch? How many patients have access to the public, private or mixed reimbursement for our product? Who are the dynamic prescribers that we should focus upon both before and after listing in a given province? How do I characterize a prescriber s patients based on the type of coverage they have access to? How do I quantify patients who stop or switch medications when transitioning from private to public payers? XPONENT TRx BY PAYER TRx by Payer allows sales professionals to better understand the influence of public and private coverage and to focus efforts on appropriate, timely, and relevant messaging for effective call planning. Visibility to total prescription volumes provides the following benefits: Segmenting the market for a new product launch Sales force sizing Enrich monitoring, call planning and micro-messaging processes Understanding Payer Dynamics 6

7 Who is paying for our drug now that formulary access has changed? Who is my competition at the prescriber level within a payer? What message is most appropriate for different payer segments? Territory Insights GPM NBRx BY PAYER NBRx by Payer measures the effect of sales effort on physicians with patients who have access to reimbursement. Payer insights by patient-level dynamic volume supplement GPM to depict product performance under the influence of specific Payer types (Private, Public, Cash, NIHB) on patient dynamic volumes by territory/sub-territory. Benchmark dynamic payer performance Understand how cost-control measures imposed by payers influence your product s prescribing Understand dynamic potential to better set sales targets at the territory level by payer type How do I monitor product performance amongst high dynamic prescribers? What patient strategies are the most impactful? GPM TRx BY PAYER TRx by Payer provides an accurate depiction of prescription market volume by payment type. It allows you to monitor and measure the impact of payer coverage on sales performance. Actionable insights gained through a better understanding of payer dynamics, at territory level, will help you refine sales projections, and more accurately compensate performance. Benchmark payer performance across territories with similar access Monitor and measure the impact of payer volumes on sales performance at any level of geography Refine sales projections, and more accurately compensate performance What payer segments are the priority for my territory / region? Where should I make changes to existing messaging to best reflect the needs of my territory / region? For further information on the advantages of IMS Payer Insights or to request a capabilities presentation, please contact your IMS Brogan representative. Understanding Payer Dynamics 7

8 QuintilesIMS Trans-Canada Highway Kirkland (Québec) H9H 5M3 (514) Contact us at Legget Drive, Tower C, 7th floor Kanata, Ontario K2K 3B8 (613) Century Avenue, Suite 300 Mississauga, Ontario L5N 6A4 (905) About QuintilesIMS CREATING SOLUTIONS FOR YOU TO DRIVE HEALTHCARE FORWARD QuintilesIMS (NYSE:Q) is a leading integrated information and technology-enabled healthcare service provider worldwide, dedicated to helping its clients improve their clinical, scientific and commercial results. Formed through the merger of Quintiles and IMS Health, QuintilesIMS s approximately 50,000 employees conduct operations in more than 100 countries. Companies seeking to improve real-world patient outcomes and enhanced clinical trial outsourcing through treatment innovations, care provision and access can leverage QuintilesIMS s broad range of healthcare information, technology and service solutions to drive new insights and approaches. QuintilesIMS provides solutions that span clinical to commercial bringing clients a unique opportunity to realize the full potential of innovations and advance healthcare outcomes. As a global leader in protecting individual patient privacy, QuintilesIMS uses healthcare data to deliver critical, real-world disease and treatment insights. Through a wide variety of privacy-enhancing technologies and safeguards, QuintilesIMS protects individual privacy while managing information to drive healthcare forward. These insights and execution capabilities help biotech, medical device, and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders in the development and approval of new therapies, identify unmet treatment needs and understand the safety, effectiveness and value of pharmaceutical products in improving overall health outcomes. To learn more, visit QuintilesIMS and its affiliates. All rights reserved. Trademarks are registered in the United States and in various other countries.