Market Access Strategies /
Avalere Reimbursement & Product Commercialization expert Lauren Barnes shares best practices for obtaining coverage and maximizing payment.

Avalere expert Lauren Barnes was recently featured on a Biotech Showcase panel discussion that focused on reimbursement as a critical component of valuation. She talked to an audience of 1,300+ biotech company executives about strategies for ensuring market access. Below is a summary of her key points.

• Successful companies typically decide on a strategy and present it to payers, rather than wait for payers to guide their products and define their markets. This is true for Medicare, Medicaid, and Commercial payers.
  
  
• Companies must talk with providers at an early stage to understand how they will perceive their product. Securing coverage, coding, and payment for a drug no longer guarantees that doctors will prescribe it. Companies must ensure that doctors are willing to assume the risk for a product, particularly as biotech drugs shift into therapeutic areas where doctors may be less willing to buy and bill. Companies can mitigate doctors' concerns by looking outside of just the physician's office and considering alternate sites of care.
  
  
• Companies should not focus solely on the time immediately post launch as an indicator of market access. It can be some time after market access before payers become aware of products, understand data, and place restrictions on products.
  
  
• Companies can benefit by shaping the market with respect to quality measures, but to do so they must be willing to take a risk and collect the requisite data.
  
  
• In addition, successful companies are those that invest the time to review all medical policies from Medicare and commercial payers, and segment those policies into variables that can affect access. Companies can then clearly identify where they have the data to work with payers to modify medical policies. Those that are able to do this successfully can proactively ensure that the market supports their product.
  
  

To access more of Avalere's expertise on reimbursement and product commercialization, please email reimbursement@avalerehealth.net.