Our clients are typically small to medium sized pharmaceutical companies, biotechnology and medical device companies as well as Private Equity and Venture Capital Investors.
Case Study 1
Problem: An existing cardiovascular product was launching with a new indication. The eligible population for this new indication was large and the existing treatment was a widely used cheap generic. Affordability for the NHS
was a serious issue.
Analysis: It was clear that on a purely health economic assessment this product in this indication compared to existing therapy would be cost-effective for the NHS but price was a concern. Consequently, there was a danger of the NHS restricting the product to certain categories of patients. International price referencing means that UK affiliates frequently have limited options regarding the published list price.
Solution: To proceed through the HTA process (NICE and SMC) at the existing list price and achieve positive assessments but at the same time approach primary care organisations and offer them a confidential price discount. Within a year over 75% of PCOs had signed up for the discount. Up to this time, pharmaceutical price discounts had been limited to the hospital setting.
Case Study 2
Problem: New diabetes product launching but fourth in class in a crowded market. First in class product was dominant.
Analysis: New product to launch had two unique differentiators from other products in class, firstly there was limited renal excretion and secondly no dose adjustment was required for renally compromised patients (a common problem in diabetes patients).
Solution: A study using CPRD data (UK primary care database) was undertaken to examine what percentage of patients using the other brands in the class were renally compromised and had not had their medications dose adjusted. The number of patients on the wrong dosage was high. The results of this study were then used in marketing messaging (get it right first time – confidence for physicians) and other materials such as budget impact tools. Fourth brand in class to launch is now second in class in terms of sales. Growth is being taken from the market leader.
Case Study 3
Problem: A brand leader in respiratory market approaching loss of patent and for first time a new product in class had been launched at a reduced cost. Some primary care organisations were beginning to consider switching to the new product in order to save around 10% on list price in a high volume class.
Analysis: Whilst it was clearly true that the new product had a lower list price and on purely theoretical basis if all patients were switched the PCO would save money in their medicines budget. What was not being recognized was that in order to achieve this saving, all patients would need to attend GP surgery to have their prescription changed and receive training on their new inhaler device. Patients were a largely elderly population, many of whom had been on their existing medicine for many years and were stable. To switch their inhaler device and medication would require considerable health care professional support.
Solution: A cost of switching economic model was developed which was very simple to use by members of the field force and healthcare professionals. The model clearly demonstrated that the cost of switching far outweighed any savings achieved in the medicines budget.