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- Reimbursement Consulting, Healthcare Business Solutions
- Healthcare Market Research
- Healthcare Education, Healthcare Education And Training
- Hotline Assessments and Patient Assistance Programs
- Expanded Access Program
- Case Studies
- Market Research - Leveraging insight from Payors
- Comparative Cost Analysis - Pharmaceuticals
- Healthcare Reform Analysis
- Health Technology Assessment - Oncology
- Reimbursement Call Center and Patient Assistance Program Design - Multiple Product Classes
- Comparative Effectiveness Review - Diabetes
- Reimbursement Training and Field Reimbursement Call Tracking Tool
- Competitive Intelligence - Urology
- Product Commercialization and Reimbursement Landscape Analysis - Oncology
- Clinical Services Evaluation - Specialty Pharmacy
- Commercialization Strategy - Deep Vein Thrombosis
- Coverage Analysis - Drug Delivery System
- Reimbursement Coverage and Coding Analysis - Vascular Stents
- Health Economic Analysis - Rheumatoid Arthritis
- Health Economics Analysis - Diabetes Mellitus Blood Glucose Monitoring
- Expanded Access
- Comprehensive Clinical Analysis and Clinical Protocol Design - Migrane
- Outcomes Research Plan - Gastroenterology
- Clinical Compendium and Gap Analysis - Pain Management
- Reimbursement Landscape Analysis - Rare Bleeding Disorders (Hemophilia)
- Disease Area Review and Burden of Illness Analysis - Oncology
- Hospital Inpatient Payor Claims Analysis - Hospital Acquired Infections
- Health Economic Analysis - Orthopedics
- Market Valuation - Opioids
- Meta Analysis - HIV (Human Immunodeficiency Virus)
- AMCP Dossier - Dermatology
- Competitive Intelligence - Infectious Diseases
- Competitive Intelligence - Contraception
- Reimbursement Landscape Analysis - Urology
- Health Economics Analysis - Crohn's Disease
- Comprehensive Reimbursement and Health Economic Analysis - Neurovascular Disease
- Patient Assistance Program Design - Insulin Products
- Health Technology Assessment - Wound Therapy System
Case Studies
Reimbursement Coverage and Coding Analysis - Vascular Stents
Insight
The vascular stent marketplace is highly controlled by governmental and commercial third-party payors. A global healthcare company was required to demonstrate the clinical advantages of their device in order to increase payment levels. Current Carotid Artery Stenting (CAS) specific DRG codes had corresponding pay rates that failed to adequately capture the technological characteristics of the client’s device, and significant clinical and economic evidence was necessary to demonstrate the advanced clinical utility of the device.Strategy
The Aequitas Group demonstrated cost-effectiveness of the device in comparison to carotid endarterectomy (CEA) by determining the incremental cost-effectiveness ratio of each approach, thereby justifying a DRG payment change.Execution
Quality of Life (QoL) changes were measured with validated questionnaires, over a month of post-procedural interval to determine whether patients treated with the device reported greater QoL improvement than those treated by CEA. Costs of the device were compared to established alternatives to justify higher third party payments. Through the design and execution of the economic and QoL study, we were able to support the reimbursement strategy, and a new DRG was obtained.© 2009 The Aequitas Group, Inc. All Rights Reserved.