Pricing & Reimbursement Assessment for an Epilepsy Drug
Task:
To assess the pricing & reimbursement environment in the anti-epileptic therapeutic area in one CIS market
Task:
To assess the pricing & reimbursement environment in the anti-epileptic therapeutic area in one CIS market
Client:
Market Access consultancy
Region:
One of the biggest CIS market
Guidelines study:
- Research of guidelines in the country available on each level: national, regional, local.
- Building-up a scheme of patient's pathway within the targeted disease.
- Overview of recommendations in the general treatment guidelines.
- Analysis, whether current clinical practice consistent with the guidelines in the country.
- Identification of the existing clinical practice (clinical standards).
Treatment infrastructure study:
- Identification of the most essential treatment centers, KOLs, national KOLs, experts in the country.
- Forming a list of potential HCPs and KOLs for the expert interview.
Deliverables:
- A roadmap of bringing an AED product into the country's market.
- A clear picture of the P&R environment in the country.
- Market and infrastructure research.
- Treatment guidelines and practices analysis.
Pricing study:
- Identification of parties that can participate on behalf of the Target (company representative / attorney-at-law / other) and timing.
- Review of the rules for price-setting (for both original and generic drugs) in the country.
Epidemiology study:
- Assessing the overall country's environment concerning epilepsy, its prevalence, incidence, mortality.
- Estimation of the target population by funneling the total target patient population.
- Estimating the overall burden of the disease in the country.
- Identification of the unmet need in the targeted indication in the country.
Reimbursement study:
- Analysis of potentially available public funding schemes for medicines (in general) in the country.
- Identification of public funding options currently used for epilepsy drugs.
- Identification of whether the local market has centralized reimbursement decision-making and the process length (if available).
- Study of requirements for public funding and key decision-makers.
- Assessment of the existing HTA mechanism and guidelines in the country.
- Time from submission to favorable reimbursement decision.
- Review of reimbursement indication per each competitive product.
- Assessment of the level of competitive products being reimbursed.
- Study of the reimbursement modes in the country: pharmacy/drug program / other.
- Risk Sharing Schemes in the country availability analysis.
- Finding out all other possible reimbursement pathways (including e.g., innovative drug/device, other than centralized reimbursement decision-making process).
- Identification of all components of the reimbursement process: what is required and what good to have (e.g., HTA report, local expert’s or patient organizations’ support) etc.
- Review of costs of submission in the country.
Key areas covered in the project:
- Market landscape analysis.
- Pricing & Reimbursement environment with regards to AEDs.
- Time and processes to achieve public funding in the country.
- Anti-epileptics treatment infrastructure overview.
- Understanding ways of the early market entry.
- Timelining the P&R pathway process.
- Analysis of available public funding schemes.
Market landscape analysis:
- Analysis of Marketing Authorization Holders of the core competitive products in the market.
- Assessment of the availability of competitive products: drug programs, Early Access Programs, Named Patient Access, targeted import, etc.
- Research on whether competitive products are being reimbursed in the country.
- Costing analysis: cost per DDD (WHO), cost per most commonly used/prescribed doses.
- Pricing analysis: drugs package, a public price per package, EXW price per package, patient discount per package (if applicable), an annual cost per patient, etc.