PAREXEL’s payer relations team offers our clients an in-depth understanding of the healthcare market at launch and beyond by combining expertise in both health policy and business. Our staff provides our clients with a strategic marketing and reimbursement plan for new products, helping manufacturers to understand how payers evaluate a new product, what information payers require to make coverage decisions, and how payers respond to alternative pricing scenarios. We also have detailed knowledge about obtaining optimal coding to distinguish novel therapeutics from competitive products. Our payer relations team provides a range of products and services to help our clients achieve their business goals. Below, we detail our payer relations services.
CODING EXPERTISE
PAREXEL helps clients navigate the complex world of healthcare code sets used by public and private payers. Our team is well versed in coding and recently published the Guide to Healthcare Coding Systems for Drugs and Biologicals. Prior to launch, we provide clients with reimbursement strategies to optimize sales immediately following market approval. If we determine that existing codes are inappropriate for a new product, our staff—building on years of professional experience—can work directly with the Centers for Medicare and Medicaid Services (CMS) to secure more appropriate coding.
MARKET RESEARCH
Pre-launch market research with the key decision-makers and users of a product is an excellent way to identify the expected clinical and payer adoption of a product and potential obstacles to its use and coverage. PAREXEL conducts market research with hospital based and private practice physicians, managed care organization (MCO) medical and pharmacy directors, nurse managers, and other clinician groups as well as patient groups.To ensure that the participants in our market research projects are true subject matter experts (SMEs), we rely on PAREXEL’s extensive Payer and Provider Expert Panel. By relying solely on trusted, reputable opinion-leaders, PAREXEL can recruit senior-level SMEs quickly and efficiently, leading to timely and high quality market research results for our clients.
CLAIMS ANALYSIS
In addition to our qualitative market research abilities, PAREXEL also delivers unmatched access to healthcare claims databases. These databases offer a wealth of knowledge about trends in healthcare utilization of drugs, biologicals, and medical devices; the frequency of diagnoses; the demographics of specific patient populations; and other important information to be considered when launching a new product. The databases that PAREXEL routinely uses for client projects include the following:
National Ambulatory Medical Care Survey (NAMCS),
National Hospital Ambulatory Medical Care Survey (NHAMCS),
Nationwide Inpatient Sample (NIS), and
National Hospital Discharge Survey (NHDS).
PAYER EDUCATION
Bringing a new product to the attention of key payer decision makers at launch is an effective way to help facilitate favorable decisions and to help eliminate delays and unwarranted denials of claims due to lack of product familiarity. PAREXEL creates customized messages for our clients and tailors communications to address payer expectations based on the depth and breadth of experience that we have gained over the past two decades of working with new product launches.
PROVIDER EDUCATION
The multiplicity and complexity of payer policies, coupled with the number of new products confronting providers and their staff each year, makes it imperative that manufacturers devote resources to educating providers about submitting claims for new products at and after launch. PAREXEL has unparalleled experience in developing provider reimbursement guides for customers, helping to prevent unwarranted denials or delayed payments from public and private payers. A reimbursement guide—along with the sales force’s knowledgeable assistance—eases the way for early acceptance of a product. In addition, new or revised provider guides, as well as short updates and push emails or faxes, can be important communication tools when changes in coding or policy occur.
