CASE - Captive Population-based MEAs: develop actuarial and pricing models and gauging Account interest on deals

Client Need

A top 5 Pharma was facing unique competition and payer pressures both on price levels and market share for one of its most important products. The opportunity to assess the viability of an innovative closed population-based agreement would have the potential to lead to transformational organizational change (from traditional go-to-market into a deal-making organization).

The Client needed to:

  1. Assess arbitrage opportunities and viability of captive population-based MEAs,
  2. Gather feedback from internal stakeholders on design of pricing schemes, evaluation of business case for Pharma and Payer and associated risks,
  3. Identify a sample of "suitable" payers/accounts for real-life testing and define pilot offering alternatives according to different account archetypes,
  4. Evaluate the interest of selected payers/accounts

Approach

A deep understanding of the product, competition and therapeutic area cost drivers was fundamental to discover arbitration opportunities underlying a successful deal. It was also important to demonstrate to each country affiliate how this scheme was superior to any current deal or any other non-population based deals.

The deal also had to be simple and clear to communicate internally and externally, core concepts were isolated from other add-on components. We were thus able to develop several offering structures based on the same core concept, but which could be attractive to different account archetypes (i.e. interested in financial benefits vs. improved outcomes). A clear and tangible business case was also necessary and had to build on sources of value truly appreciated by the payer. A win-win agreement.

Account feedback during the design process was fundamental to ensure market receptivity to the agreement and establish first contacts to actual follow-up negotiations. Accounts were short-listed - we supported local teams with training and workshops to successfully engage with accounts during the meetings. Results of account discussions defined recommendations to top management on a proposed plan forward.

Results

  • Over a quick 6 months timeframe, Product population-based MEA was drafted, studied and shared with Global Pricing, country affiliates and selected Accounts
  • Definition of profitable commercial offerings
  • Effective support to training and facilitating Account discussions
  • First 2 deals were closed in Spain

Designed and developed by: Brand039