Case Studies

Healthcare Reform Analysis

Insight

A global pharmaceutical company was anticipating the impact of health care reforms and other proposed regulatory changes on their forecast for 2010 and beyond. In addition to the complexity of the reforms under discussion and the ambiguity of the resulting effects, the company had an extensive and complex portfolio of therapeutic products and needed to understand the potential effects of the reforms on future revenues.

Strategy

The Aequitas Group’s policy team developed a plan to systematically identify discrete elements of proposed legislation (e.g., America’s Healthy Choice Act of 2009, America’s Affordable Health Choices Act of 2009, US National Health Care Act, etc) and policy changes that could have an impact on the client’s product portfolio. Reimbursement and finance teams worked in parallel to develop a framework for examining the impact of the proposed reform legislation and other changes over several time horizons.

Execution

The Aequitas Group parsed bills and other regulatory sources to capture key elements of national reform, as well as proposed Medicare and Medicaid changes to inform a complete analysis. Expert opinion was brought to bear in ranking these elements by probability of realization and likely year of implementation. The Aequitas Group then conducted a qualitative survey and relative impact analysis of each product in the client’s portfolio against each element individually and in aggregate. These insights, in combination with a payor mix analysis, allowed the client to narrow their confidence interval around revenue forecasts for 2010, and proactively develop strategies for maximizing revenue under the reforms and other changes at the brand level.