Case Studies

Comparative Cost Analysis - Pharmaceuticals

Insight

A global pharmaceutical company had a product approved for reducing the signs and symptoms and slowing the joint progression of joint damage in adult patients with moderate to severe rheumatoid arthritis. The product was one of several new agents used for treatment when other, more established pharmacological therapies failed to control the disease. The market required an evidence-based analysis to justify shifting payment for the product from Medicare Part B to Medicare Part D.

Strategy

The Aequitas Group determined that a publication plan should be developed for manuscript submission and abstract presentation at a disease-specific conferences as well as in economic medical journals. In addition, a Centers for Medicare and Medicaid Services information-dissemination plan of action was developed for the local and national levels.

Execution

The Aequitas Group compiled the clinical evidence supporting the appropriate use of the agent in the continuum of care for rheumatoid arthritis. This evidence included a comparative cost analysis that demonstrated that the product was as cost-effective as the comparative agents. The analysis was provided to the Medicare Payment Advisory Commission and other federal oversight agencies.