Reimbursement
Reimbursement is the payment by a public or private insurer or 'payer' to a health care provider for the costs incurred in using your technology.
Strategic reimbursement planning and execution involves the development of comprehensive reimbursement plans that help grow your business and successfully commercialise your product.
Developing your reimbursement strategy will broadly follow these steps:
Understanding how the reimbursement system in the targeted country works in regard to your developing product. Research the existing reimbursement systems and their applicability to your product. This will help to formulate your reimbursement pathway mapping.
Consider data that would convince the identified reimburser to provide reimbursement. There are four parts to complete this process: creating a value story, economic model, support of clinical data, and getting feedback from decision-makers.
Implementing your reimbursement strategy to obtain the funds you planned for. This means applying to the right bodies for national endorsement and assessment. In the UK, the National Institute for Health and Care Excellence (NICE) may assess the clinical and cost-effectiveness of the product compared to current clinical practice. Depending on the results, the assessor may recommend the product for routine clinical use
Best Practices
Leverage our deep knowledge and tested strategies.
Obtaining reimbursement can be a long and complex process that may require considerable funding for evidence generation through clinical trials and health economic evaluation. Ensuring you know the key influencers and decision-makers, and how to expose them to the benefits of your solution is also important.
What you need:
Up-to-date product profile, clinical relevance and results of your solution
Early dialogue with HTAs to inform your application
Engage with other key stakeholders before submission
A business case which clearly demonstrates how the product meets unmet patient needs and the implications on the current pathway
Get in touch
If you need help with your reimbursement strategy, get in touch to discuss how Hardian Health can help.