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Payers and Prior Authorizations (PAs): The Need for a Nuanced Management Strategy by Enid McDonough
PAs can impose significant limits on market access and uptake for pharmaceutical products, and their application should not be oversimplified. Over the past 12 years, most of my payer research has included an element exploring and analyzing the PAs that were likely to be imposed on a new agent to market or an older agent facing market disruptions (a branded or generic competitor, a new indication, e.g.).
Using DPS®/Conjoint to Formulate a Competitive Response by RG+A
The contraception franchise of a major pharmaceutical company was under competitive threat by a discount product coming to market within two years. RG+A was engaged to help the client understand the impact to their franchise – both inline and pipeline products – and to identify variations of the competitor’s product profile that would have the greatest impact on share. RG+A employed our DPS®/Conjoint approach to simulate prescribing behavior among 400 providers under current market conditions as well as two future market scenarios. Respondents were split into monadic cells and exposed to best, base, and worst-case competitor profiles, and then taken through a trade-off exercise based on potential endpoints for the competitor product. Using this approach, RG+A was able to provide reliable forecasting under variable conditions, and tie share performance to specific components of the competitor’s product.
Contracting Beyond Rebates and Discounts by Enid McDonough
As provider reimbursement systems move toward compensation for success rather than service, some health plans are encouraging manufacturers to take on some of the market risks for new agents in exchange for preferential management. As pharmaceutical companies seek to develop new and successful market access strategies, they should proactively approach certain types of plans with offers of performance-based contracts.
Forecasting for Multiple Indications within the ADHD Market by RG+A
RG+A’s client needed to make a go/no-go decision for a Phase III clinical trial for a novel ADHD medication. It was unknown whether or not the product would get either an adult or adult and pediatric indication. Additionally, this company needed to know who would be most likely to use this product and what uptake and peak share might be given various scenarios of the product’s final attributes. RG+A used a combination of DPS® and QTM® methodologies to deliver answers to all of these major research questions along with a recommendation about how to proceed with the Phase III clinical trial. RG+A identified differences in adult compared to adult and pediatric indications, which physicians and patients were mostly likely to adopt this therapy, as well how variations in product attributes would impact uptake and peak share.
Generic Competition Assessment Among Payers Using PV Scope® by RG+A
Facing imminent generic competition for their branded respiratory product, a pharmaceutical company engaged RG+A to help them understand the complex payer stakeholder landscape and to provide guidance on key strategies to strengthen the brand’s position with payers at present and following the generic launch. RG+A used our PV Scope® approach to iteratively engage a diverse group of payers in online, telephone, and bulletin board interviews. RG+A was able to provide the client with specific guidance on key levers that would be important to payers as well as insight on a major threat from a branded product that might thwart optimal market access if not challenged.
World Congress 2015 by RG+A
During this session we will: Identify drivers and barriers to successful relationships between managed care and manufacturers of oncology agents Explore evolving approaches to managing high-cost oncologics as costs of agents rise and combination therapies become more the norm Pinpoint the perceptions, attitudes and behaviors that drive successful plan-manufacturer relationships Learn why payers believe that their favorite companies, brands, and account teams provide superior value
Managed Care’s Perspective: Best Practices in Payer-Manufacturer Relationships by Kevin Kelly
In Managed Care’s Perspective: Best Practices in Payer-Manufacturer Relationships, RG+A explores the relationship between payers and manufacturers from the perspective of managed care professionals. Using original research from RG+A’s Health Payer Council, we illustrate key differences between contracting and partnership, and the general perceptions that payers have when engaging with biopharma manufacturers.
Using Co-Creation with Payers to Support Optimal Product Profile Development and Clinical Trial Design by RG+A
RG+A’s client sought to optimize the post-launch value of their early stage respiratory asset by incorporating key payer perspectives into product strategy and trial design in support of high likelihood of reimbursement. RG+A used our Co-Creation approach to engage payers from our Health Payer Council community directly in the development of an optimal target product profile (TPP) and viable trial design to support the client’s post-launch objectives. RG+A identified cost containment from prevented hospitalizations to be a central issue for payers, and we made recommendations on a trial design that would support the development of both clinical and HEOR data along with insights into hospitalization reduction.
Applying Dynamic Practice Simulation (DPS) to Development and Commercialization Strategy by RG+A
Shire faced multiple issues in creating a development and commercialization strategy for a pre-Phase II asset in the US and three non-US regions. One pivotal challenge involved forecasting the relative market potential for two distinct indications. RG+A conducted a Dynamic Practice Simulation® (DPS) study with 400 physicians in seven markets. The split sample design allowed Shire to analyze how each indication would perform as the launch indication and as the second indication. The study showed that indication A would gather more use than indication B. For clinical development, it also pinpointed pivotal clinical endpoints, patient targets, and possible combination therapies. For commercial development, it pinpointed physician segments, key market messages, and how both of these varied from region to region. After reviewing these results, Shire continued development of indication A, but not B.
Forecasting Physician Treatment Decisions across Multiple Lines of Therapy by Bruce Duncan
Our most recent white paper describes a new approach for forecasting the impact of future events based on RG+A’s pioneering Dynamic Practice Simulation® methodology. The method, called Dynamic Practice Simulation® Line of Therapy , simulates the treatment decision process by presenting physicians with a diverse set of realistic multiple myeloma patient profiles, having them treat the patients, and receiving feedback after each treatment on its effectiveness. Treatment decisions are assessed over three lines of therapy and include decisions for both induction and maintenance therapy. Physicians make their treatment decisions under two scenarios – the market as it currently exists and a future market after the launch of an innovative new treatment.
Better Answers with Imprecise Data by Bruce Duncan
The ability of market researchers to provide precise forecasts is critical to decision makers. Precise forecasts are very valuable. A 21% share estimate with a confidence interval from 20% to 22% tells you all you need to know if your threshold for launching is 20%. Imprecise forecasts are of less value and sometimes, no value. A 20% share estimate with a confidence interval from 12% to 30% isn’t going to be of much value for making the same launch decision.
Developing Competitive Contracting Strategies using Contract Simulation® by RG+A
RG+A’s client was preparing for the launch of a product for which there was a likely launch of a competitor within the same timeframe. They identified payer contracting as critical to meeting their brand access goals and engaged RG+A to help understand the contracting process from end to end. We utilized our proprietary Contract Simulation® approach, which consisted of exploratory qualitative and an online simulated contract negotiation between payers and RG+A moderators. This research was able to uncover the primary driver of coverage for the client’s product and identify optimal pricing and discounting approaches to gain preferred footing over the competitor’s product. RG+A’s recommendations assisted the client in the development of a focused contracting strategy that was more likely to have success among payers out of the gate.
Contracting Strategy Development using Qualitative Conjoint to Segment Community Oncology Practice Managers by RG+A
Client viewed contracting with private practice oncologists as a key to competitive success for their third-to-market agent. RG+A conducted a Qualitative Conjoint exercise, where each conjoint “card” presented a simplified contract, complete with calculations an oncology practice manager might use. We ran the conjoint first and the qualitative portion second. This order enabled us to segment oncology practice managers into two groups: Profit Seekers and Loss Avoiders. The two groups demonstrated clear and significantly different preferences in contracting. This information allowed Client to develop a contracting strategy that achieved goal by focusing on the Profit Seekers while still attain acceptable share from the Loss Avoiders.
Attribute Importance Ratings: Are We Learning Anything We Don’t Already Know? by Bruce Duncan
Attribute importance is a key information need for marketers. An understanding of attribute importance can help explain physician prescribing, it can help identify competitive advantages and disadvantages and it can provide guidance on what needs to be communicated in advertising and promotion. Attribute importance can also be a basis for segmenting and targeting physicians.
Forecasting and Strategy Development for a Neurological Product by RG+A
Ahead of availability of clinical data from their final set of trials and under significant time pressure, a pharmaceutical company engaged RG+A to help create an accurate forecast for the performance of a neurological product upon approval of the product’s second indication. Using a two-element approach consisting of qualitative interviews and RG+A’s Dynamic Practice Simulation® method, RG+A was able to identify key factors impacting physician likelihood to prescribe and to recommend changes in the brand’s communications approach to boost receptivity to the product. RG+A confirmed the client’s previously forecast peak; however our research showed that the shape of the curve would push that peak out further than previously expected.
Feature Optimization via Qualitative Conjoint to Combat Competitive Threat in the Vascular Device Space by RG+A
Facing a competitive threat from a new entrant to the market, RG+A’s client – a manufacturer of vascular devices – sought to focus their product development investment in order to optimize their response to this threat. RG+A employed a Qualitative Conjoint approach, using telephone-based qualitative interviews to explore competitive technologies, online conjoint to identify features with the greatest impact, and a Monte Carlo model to estimate win rate in head-to-head comparisons. RG+A was able to recommend the three features that would drive the greatest benefits to competitive response and long-term share.
Driving the Right Decisions: Three Steps by Roger Green
Marketing Research provides the greatest benefit to internal stakeholders when it helps them “predict the future.” Predicting the future can involve answering several very different kinds of questions. For example, “How should I develop this asset?” “Should I acquire a competitor?” “Which message or campaign will achieve the highest market share?” and “Who in my target audience is most likely to purchase my new product?” all ask for different types of predictions.
So Why Do We Need Surveys Anyway? by Roger Green
Within the sphere of marketing research activities today, few have lower prestige than the simple survey. If you read the blogosphere, you see questions asking whether primary marketing research will be dead in 10 years (or maybe 5), whether Big Data will eliminate the need for surveys completely, and whether traditional “data collection” has a future (see my recent blog post, where one commenter stated, “nobody wants to do data collection anymore.”) I found this response particularly interesting in a world where virtually every informed person I know spends an increasing amount of time online doing research, swapping ideas with colleagues, and gathering information that affects all corners of one’s life.
Implications for ASCO’s cancer drug scorecard by Tim Deckman
A recent article in the Journal of Clinical Oncology, presented at the 2015 ASCO conference, has put forward a “scorecard” for judging oncology medications to be used by physicians and patients. This scorecard was put together by an ASCO task force and is the culmination of over 8 years of work. The task force’s objective was to create a tool that could be read and interpreted by both physicians and patients and could guide discussion about treatment options. The scorecard assigns a value from 0 to 100 (in some cases 0 to 130) based on the efficacy and side effect profile along with the price for all treatment options.
Product Positioning for an Innovative In-Home Medical Device by RG+A
RG+A was engaged by a global device manufacturer to position an innovative device for in-home use in the EU5 markets. The specific challenge was that key feature that made the device attractive to patients had the potential to lower profits for home medical equipment resellers. One round of qualitative interviews determined that if our client could neutralize perception on this profit-lowering feature, the product’s other benefits would garner interest and support from resellers. A second round of qualitative interviews explored three ways to encourage resellers to appreciate the benefit to patients and identified a core value proposition that motivated resellers to stock the product. RG+A worked with our client to convert this into a complete positioning structure. In the final round of research, interviews with a significant portion of the reseller communities pinpointed specific messages that credibly supported the core value proposition and reasons to believe. Our client is currently preparing for full launch in these markets.
Hazardous Drug Detection for Employee Safety by RG+A
RG+A was engaged by a global device manufacturer to help determine market response to a potential new device for testing for the presence of trace hazardous drugs in hospital pharmacies and infusion areas. The client sought to determine whether to continue development of the product and in what form. Also, the research needed to determine drivers and barriers to use, pricing constraints and the existence of any segments that could help narrow targets for outreach and promotion. In the research, RG+A tested adoption and usage rates for Version 1 and Version 2 of the device. RG+A conducted telephone-based, web enabled interviews with key pharmacy directors, nursing directors and hospital based safety officers, and incorporated the findings into a Monte Carlo model. The model showed that >75% of all test volume will come from a small number of heavy users who consider themselves “definite” to use Product X. Also, if the estimate includes hospitals considered “less than certain” to adopt, 75-80% of all tests come from hospitals that test more than once per week. Qualitatively, RG+A established the likely uptake for Version 1 in certain hospitals, that 20% of hospitals were more likely to adopt Version 2 and the relative barriers to adoption and uptake for each version.
Assessing Market Potential and Development Strategy by RG+A
RG+A was engaged by a diagnostics manufacturer to help determine the best business approach to for their new prostate cancer screening product – continue development, sell the asset, or discontinue. RG+A conducted telephone-based mini-groups among key stakeholders, and incorporated the findings into a Monte Carlo model. The model showed that the product would reach peak revenue of over $400M in 6 years with a 49% chance of hitting $50M within 2 years. It also identified a low-cost targeted sales and marketing approach that would increase forecast Year Two revenue by 29%. These findings were pivotal in the client securing $60M in venture funding to continue development of the product for launch in 2016.
Pricing and Volumetric Forecasting for an Orphan Drug by RG+A
BioMarin engaged RG+A to help them determine the “right” launch price for their orphan drug, Kuvan — $0.10/mg or $0.15/mg. RG+A developed a pricing and volumetric forecasting model using a Qualitative-to-Modeling® (QTM®) approach based on patient flow models developed with BioMarin and triad interviews with geneticists, dieticians, and caregivers or patients. The study revealed that BioMarin needed to conduct extensive market development work, but that Kuvan could sustain a substantially higher price of $0.29. Announcement of the higher price caused a 20.2% leap in the price of BMRN stock, while the incremental revenues supported a range of market development activities.
Press Release:
RG+A Announces Promotions and New Hires to Keep Pace with Company Growth by RG+A
Staffing additions and promotions target research and methodological leadership as well as expansion of RG+A’s sales team RG+A has recently implemented some key staffing changes to support the company’s ongoing growth in its biopharma forecasting and device/diagnostics lines of business.
RG+A Rated Among First Place Speakers at PMRG Institute by RG+A
The Pharmaceutical Marketing Research Group (PMRG) released speaker evaluations from their annual industry conference, the PMRG Institute, held recently in New Brunswick, NJ. Roger Green and Glenn Hamilton, MD’s talk titled Lessons from an Online Payer Community: Increasing the Importance of Guidelines, was popular with the audience and was among the highest rated presentations of the two-day event.
RG+A Announces Plans To Release “Winning and Losing with Payers” Study by RG+A
RG+A announced formal plans to release “Winning and Losing with Payers”, the study that served as the platform for the firm’s presentation it gave at the Pharma CI Conference and Exhibition, September 9, 2014 in Parsippany, NJ.
U.S. Access and Reimbursement for Biosimilars Far from Guaranteed by RG+A
Ongoing dialogue with RG+A’s Health Payer Council® underscores the challenges that biosimilar manufacturers will face from U.S. payers. According to members of RG+A’s Health Payer Council® (HPC®), an online community of managed care pharmacy and medical directors, biosimilar products are likely to continue to face the same scrutiny and pricing pressure from payers as their innovator counterparts, as well as competition from other biosimilar products.
RG+A Continues its Long-Standing Commitment to the Trenton Area Soup Kitchen and Says Farewell to an Exemplary Leader by RG+A
RG+A’s President/CEO, Roger Green along with staff continued a decade-long commitment to giving back to the community by volunteering at the Trenton Area Soup Kitchen (TASK) to serve lunch as part of an event titled “Marty Green’s Lunch,” in honor of Marty Green, Roger Green’s late father. In addition to the RG+A team volunteering their time to provide meal services and material support to Feeding America, family, friends and business partners also made financial contributions online through the Marty Green’s Lunch Set the Table™ page – a fundraising platform within Feeding America’s website.
RG+A Innovates New Research Approach Targeted at Complex Diseases by RG+A
RG+A, a leading healthcare marketing research and consulting firm, recently launched an innovative new research approach that extends its flagship product, Dynamic Practice Simulation®. Called Dynamic Practice Simulation Line of Therapy, this new offering is designed to overcome the challenges presented to forecasters in predicting performance for products that have complex treatment protocols that may extend through several lines of therapy.
RG+A Teams with Trenton Area Soup Kitchen to Battle Hunger by RG+A
RG+A’s President/CEO, Roger Green along with staff, pictured above, celebrated ten years of giving back to the community by volunteering at the Trenton Area Soup Kitchen (TASK) to serve lunch as part of an event titled “Marty Green’s Lunch,” in honor of Marty Green, Roger Green’s late father. RG+A has been partnering with TASK for a decade, providing volunteer efforts in meal services as well as material support to Feeding America, formerly known as America’s Second Harvest. Staff members, family, friends as well as business partners also made financial contributions online through the Marty Green’s Lunch page – a virtual food drive site through Feeding America’s website.
RG+A Expands Leadership Team with Appointment of New Executive Vice President and Chief Operating Officer by RG+A
RG+A, a leading healthcare marketing research and consulting firm, recently named Kevin M. Kelly as its new Executive Vice President and Chief Operating Officer. In this role, Mr. Kelly will drive results for the company’s clients by creating seamless flow among RG+A’s business functions – integrating strategy and planning, business development, customer relationship management, project management and execution, and business operations.
Roger Green + Associates, Inc. Now Known as RG+A by RG+A
Roger Green + Associates, a leading healthcare marketing research firm announced that from today on, it will be known as RG+A. The streamlined moniker reflects an enhanced focus on meeting clients’ research and insight development needs in an increasingly complex and challenging world.
Reconsidering the Value of Small Samples in Marketing Research by Bruce Duncan
Do you remember the famous line from Animal Farm, “Two legs bad, four legs good”? I suspect that we quantitative researchers have a similar one that goes “small samples bad, big samples good.” Small samples make us nervous. We can’t believe they are representative or that they can capture the diversity of a large population. We have visions of extreme groups dominating the results. When we hear “small sample,” we fear the outcome will be misleading. The time has come that we should be reconsidering the value of small samples in marketing research.
Lessons in Simulation 1: How a Negative Debate Led to a Positive Solution by Roger Green
Prescribing simulation emerged 20 years ago from the verbal and philosophical equivalent of a food fight over the best way to test a physician’s price sensitivity for medicines. (Irony alert: back in those days, doctors never cared). There were fundamentally two camps: conjoint and monadic. The conjoint camp argued that a basic choice exercise could indicate the relative importance of price in the offering for a new pharmaceutical as well as thresholds at which price beings to matter. The monadic camp argued that any method in which physicians could manipulate price of a medicine was inherently flawed.
It Took Twenty Years to Become an Overnight Sensation by Roger Green
At a Spring PMRG meeting, the highest rated presentation, given before a standing-room-only audience, debuted a new mode of marketing research called patient simulation. The presentation focused on how this method provided more reliable data than traditional allocation and estimation methods and improved response and interview completion rates dramatically.
Can Patient Chart Pulls Help Predict Physician Behavior? by Tim Deckman
Patient chart pulls offer significant advantages to allocation studies, but come with their own set of weaknesses. In a patient chart pull, physicians bring actual patient charts into the study and relay information about their patients and their treatments to researchers. One benefit of a patient chart pull is that they can offer a wealth of information about real-life patients. Researchers can look at physician treatment decisions across any of the patient characteristics collected.
Estimating physician treatment behavior with allocation – we can do better! by Tim Deckman
Predicting how physicians will act in the future is at the heart of almost every healthcare commercialization challenge. Having accurate information on how physicians are using currently-available medications as well as how likely they are to use future medications informs a multitude of decisions, from pricing to positioning to in-licensing, among others. For example, creating a launch forecast for a new drug is an extremely demanding task, and there is too much at stake to risk having anything but the most accurate information possible on future physician behavior.
Can Qualitative Research Be Used to Detect Segments? by Bruce Duncan
Many factors determine sample size for qualitative research. They usually include practical considerations such as size of budget, number of unique groups being interviewed and in the case of in-person, the number of cities in which interviews are being conducted. They may also include subjective “comfort” factors such as what has been done in the past and good old “gut feel” for what will be sufficiently reassuring and persuasive to decision makers.
Everything I Should’ve Known About Urgent Care Centers But Didn’t by Colin DiBenedetto
What are urgent care centers and how many of them are there? Urgent care centers (UCCs) are typically stand-alone locations where a person can see a medical professional for an unexpected acute condition or event. Such events might include respiratory conditions, nausea and vomiting, diarrhea, urinary tract infections, rashes, insect bites and headaches, minor sprains, strains, cuts, fractures and the like. Urgent care facilities differ from primary care offices in a number of ways: no appointment is necessary, operating hours are typically longer and include nights, weekends, and holidays, and expanded services are typically available (e.g., x-ray, lab services, casting).
Failure is not an option by Kevin Kelly
Regardless of what we call it – business intelligence, customer advocacy, decision support – the fact of the matter is that the needs and expectations of marketing research’s customers have evolved, and we as an industry need to evolve with them. Whether you are a marketing research supplier or you work within a client-side department, “value” has become the yardstick by which we are all measured.
Telling Suppliers Your Project Budget by Bruce Duncan
There seems to be an unwritten rule that says you should never share your project budget with a market research supplier. It probably derives from a concern that letting suppliers know your budget is an invitation for them to take advantage of you. You will end up with three bids all on or near your budget whether that is the true project cost or not.
How Should Marketing Research Resolve Its Identity Crisis? by Roger Green
Over the last ten years, colleagues in marketing research have, like Ms. Capulet, lamented the name of our profession. We’ve seen the groups that execute marketing research in major biopharma companies shift their names to labels such as “Business Intelligence,” “Customer Insights,” “Business Insights and Analytics,” “Marketing Sciences,” “Disease Class Analytics”— very nearly anything except for… “Marketing Research.”
Balancing Process and Red Tape in a Small Professional Services Company by Tim Phelan
Standard operating procedures (SOPs) aren’t always glamorous, but they can be vitally important to ensuring a healthy and efficient organization. But how do you know when too much process has turned your organization into a bureaucracy, where employees are ignoring independent decision making in favor of blindly adhering to some steps in a training manual?
The Four-Month Black Hole by Roger Green
Last week, I called a client who serves of CEO of a publicly traded company to discuss a study we had recently completed. With study results and models in hand, he was in the process of negotiating a major acquisition. He stressed how helpful our work was in guiding him to a “win-win” posture. When the discussion turned to future projects, he said, “I’m too busy to think about anything until at least July.” However, when I asked about future strategic challenges, he described a pivotal issue that will require a decision in four months.
Pharma Market Research Conference 2015 by Roger Green, Bruce Duncan, Kyle Martin
Historically, healthcare stakeholders have viewed treatment guidelines as one path to assuring consistent application of high-quality healthcare. In theory, utilizing guidelines guarantees excellent care and a positive cost-benefit profile. In practice, it has never been this simple. Development and enforcement of appropriate guidelines have always presented significant challenges to healthcare systems and insurers. Over the past year, the issues has become more challenging, as an explosion of specialty drug spending has made it impossible for health systems to afford therapies that might prove cost-beneficial in the long run.
Webinar: Forecasting Across Lines of Therapy by Tim Deckman
This webinar presentation will describe a new approach for forecasting the impact of future events for complex diseases. We will show how the method simulates the treatment decision process by presenting physicians with a diverse set of realistic patient profiles, having them treat the patients, and receiving feedback after each treatment on its effectiveness. Treatment decisions can be assessed over three lines of therapy and can include decisions for induction and maintenance therapy. Physicians make their treatment decisions under two scenarios – the market as it currently exists and a future market after the launch of an innovative new treatment.
Presentation: Forecast Treatment across Multiple Therapy Lines by Kevin Kelly, Tim Deckman
Oncology, respiratory diseases and diabetes all have diverse patient populations who receive multiple lines of therapy involving many different combinations of drugs and drug classes. The difficulty of the forecasting task is magnified further with the selection of subsequent lines of therapy often depending on how the patient responded to previous therapies. Information that fails to consider these complexities will not only be inadequate, but worse may be very misleading.
PMRG Connect 2015 by Roger Green, Colin DiBenedetto
This presentation will address the increasingly complicated landscape of hospital products. Specifically, it will explore how research can integrate the views of multiple key hospital stakeholders (in this case ID Pharmacists, Emergency Department Directors, and Infectious Disease Specialists) to arrive at a pricing recommendation. The presentation will explore both the value of such an integrated dialogue as well as technical and methodological considerations to ensure its success.
Doing More with Less: Utilizing Small Sample Analytics to Get the Most Out of Your Research Budge by Kevin Kelly
In this presentation, delivered during a recent pharmaceutical market research conference workshop, RG+A’s methodology experts discuss the viability of small sample analytics. Through multiple case studies that cover forecasting in the orphan space, feature optimization for a medical device, and fast estimation of the potential of an in-licensing opportunity, you’ll learn the three key takeaways of small sample approaches and understand how to put them to work for managing risk and creating certainty in your business.