Gaining public and private reimbursement for a pharmaceutical product or medical device is a critical milestone for our clients. However, it is often only one of several critical milestones, each of which can greatly affect both a product's commercial success and how accessible it is to patients. In some cases, an unfortunate proportion of patients can experience great difficult in accessing reimbursed therapies because of an inadequate degree of capacity existing within the health system. Sometimes, this can be due to a lack of resources, though sometimes there are resources or channels that can be freed up to utilize capacity more effectively.
This situation is especially prevalent in the context of highly innovative products that require significant health system resources for specialized screening, diagnoses, treatment or monitoring of patients. What this means is that there can often be constraints, bottlenecks or under-utilized channels in the healthcare system that will preclude patients from getting the drugs or medical devices that they are actually eligible for reimbursement coverage on. This is certainly a barrier to a manufacturer's sales strategy, but more importantly, a barrier to patients getting the drugs they need. It is especially frustrating for companies that anticipate upcoming competition or loss of exclusivity for their patented therapies.
There can often be actions taken to mitigate or even eliminate these barriers through the opening up of new efficient channels, though not before they are properly identified and understood. Pathway Advisory Services works with clients to do just this, through taking a holistic view of the health system, as opposed to focusing solely on obtaining public and private reimbursement. Our clients benefit from the insightful environmental scans of all factors that may impact, both beneficially and adversely, their product's ability to reach the patients their product was created to help.