On August 6th at 12 P.M. (EDT), Gary Rice and other experts are coming together for CMR Institute’s webinar, Navigating and Selling in Today’s Specialty Market. They will discuss recent changes in the specialty pharmaceutical market and explore how healthcare sales teams can benefit from these opportunities.
The standard registration fee for the webinar is $149. CMR Institute is offering Drug Channels readers an exclusive opportunity to register for $75 via THIS LINK ONLY. (Please note that registration via the CMRI website requires a $149 registration fee.)
Developing a Meaningful Value Proposition for Your Specialty Product
by Gary Rice RPh, MS, MBA, CSP
Vice President of Clinical Services at Diplomat Pharmacy, Inc.
The following are some of the key areas that sales teams need to address to formulate a value proposition that resonates with payors, using hepatitis C virus (HCV) products as an example.
Understand the payers' point of view. Until recently, specialty drugs have primarily addressed rare, orphan diseases. Since the introduction of new specialty agents that could cure HCV, physicians have a new option to treat millions of patients. However, payers have been increasingly concerned about the cost of HCV specialty products, which can exceed $90,000 for some regimens. Unlike other treatments that spread costs out over time, specialty regimens for HCV are associated with significant costs upfront for a 12 or 24 week regimen with a high cure rate.
Determine total value based on a product's regimen, risks, costs, and success rate. Demonstrating cost-effectiveness is still a critical step to establishing value. Sales teams need to move the discussion from questions of cost—and even long-term cost-effectiveness—to one of value. Just as a drug’s cost is about more than the price of a pill, its value is about more than its ability to treat a condition.
The value of a product hinges on four basic variables:
- Regimen: For specialty products, simplicity and convenience increase value. Generally speaking, this means that products with fewer doses have higher value than those with multiple doses. The same is true for easier-to-take oral products versus injectables.
- Risks: Most drugs have the potential for side effects and adverse events. These can range from occasional nausea to more serious issues like kidney damage or stroke. As the risk of serious side effects increases, a drug’s value tends to decrease.
- Cost: PBMs and health plans are not solely concerned about the price of a single pill or injection. What matters is the total cost based on the number of doses required per course, the courses required per patient, and the potential patient population.
- Success rate: Success is defined and measured differently for various types of treatments. For HCV treatments, success is a cure measured by rates of sustained virologic response (SVR).
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How each variable is weighted varies depending on the situation. For example, a HCV patient with serious liver damage may be more willing to accept a lower success rate than an asymptomatic HCV patient. A drug’s value also must be evaluated against the value of alternative treatment options.
Use data collection and analytics to identify the best candidates for treatment. Many specialty products, including those that treat HCV, have a significant upfront cost and a long-term payback period. For such products, identifying the best treatment candidates is critical to raise success rates and ensure appropriate use. Companies with specialty products should apply their data and analytics expertise to identifying the best candidates for treatment in terms of those “most in need” and “most cost-effective to treat.”
Leverage patient education and support services to improve adherence. The more expensive the treatment, the more critical adherence becomes. This is especially true when your product is competing against other treatments with simpler regimens. Some insurers have limited patient access to HCV drugs by implementing a “one and done” policy, in which an adherence failure eliminates further coverage.
Develop strong relationships with patient advocacy groups. Advocacy groups play an important role not only in the HCV landscape but also for oncology and less common diseases. Sales teams should seek opportunities to partner with these groups at the local, state, and national level by providing education and support.
The bottom line: Specialty drugs have changed the game, and sales teams should be prepared to demonstrate value and take positive actions to increase value.
To learn more from Gary Rice and other industry experts on how to develop a meaningful value proposition for your specialty product, join CMR Institute’s webinar, Navigating and Selling in Today’s Specialty Market on Thursday, August 6, 2015 at 12 pm EDT.
The standard registration fee for the webinar is $149. CMR Institute is offering Drug Channels readers an exclusive opportunity to register for $75 via THIS LINK ONLY. (Please note that registration via the CMRI website requires a $149 registration fee.)
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