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Getting payer insights for reimbursement strategy

Ryan Amin

Scott Howell, head of patient access at Genentech, led a panel at a Life Science Ventures Summit hosted by the Kauffman Foundation on the topic of reimbursement strategies. Howell directed the panel, consisting of Christine Bunt, Danielle Zurovcik, Steve Rosenberg and Sean Duffy, on the sub-topic of payer insights (0:46:36-0:50:56).

The panelists weighed in on the subject from different perspectives of the industry including digital, medical device and biotech.

What are they looking for? - A year before launching, Rosenberg hired his first reimbursement person to gain a perspective on what payers are looking for in evidence packages. "Payers, in general, will only look at published literature," said Rosenberg. "If it is not published they can say they want that second step of peer review." That second step can add another year to the startup plan and become a waste of money, time and effort.

Make your customers money - "If you go to urologists and ask them how they would use the device, they have entire sheets of CPT codes," said Bunt. "You can identify codes, plot them all together and you have half your reimbursement strategy already there." She emphasized the importance of fitting a product into a setting where the customers can clearly see value.

Weekly Wisdom from Kauffman is a regular feature on eMed highlighting helpful advice from the Kauffman Foundation.

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