Case Studies  /  Market Access and Reimbursement

Assessing hospital reimbursement dynamics for a post-operative pain medication

Challenge

Client sought to understand reimbursement dynamics that might influence uptake for a post-operative pain medication (e.g. quality metrics, guidelines).

Approach

  • Assessed relative near-term impact of a host of factors including IDN formulary, Joint Commission, quality metrics, opioid reduction initiatives and guidelines
  • Interviewed range of external stakeholders (e.g., Hospital CEO, IDN Chief Quality Director) and numerous internal experts
  • Conducted secondary research and reviewed prior internal assessments and brand plans

Results

  • We uncovered a number of opportunities to strengthen access which our client had not previously considered
  • Opus synthesized recommendations around value proposition, quality metrics, formulary positioning and overall targeting. The work was well-received and client subsequently approached for an additional project

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