As with many novel biologics and combination products, reimbursement is usually not established at product launch. As a result, your customers will likely need support in the early stages of your product launch to ensure that the technology is utilized, appropriately coded and billed, and consistently covered and paid.
Argenta’s Reimbursement Field Team provides unique market adoption services for our clients. Gaining coverage for your new drug or biologic in today’s complex healthcare system often requires a field reimbursement infrastructure that complements the sales structure, such that the clinical and reimbursement objections or concerns can be addressed simultaneously, without putting your sales force in the position of having to support reimbursement.
Because staffing needs for these issues can be difficult to gauge, Argenta has created an experienced Field Team that companies can outsource to at any point in a product’s life cycle. Obtaining appropriate coverage and reimbursement policies for new products or an established product with a new labeled indication begins by working with the payers. We have a reputation for using our experience, contacts and resources to craft and deliver effective clinical and economic messages to payers. Key to our approach is a focus on patient access to care.
Argenta’s field team also has the capability to work closely with our clients’ customers to ensure that they understand how reimbursement for new technologies works and to help set realistic expectations for the timing of coverage and payment of these technologies. We accomplish this by working with physician offices and facilities to ensure that they understand billing and coding for the therapy.
Payer Advocacy
When a payer has established a non-coverage policy, the existing policy does not adequately provide coverage or reimbursement, or a payer may have a more restrictive policy than the majority of other plans, implementing a payer advocacy plan may be appropriate.
Successful payer positioning relies upon the physician community developing medical necessity for patient care. To improve patient access to our clients’ products and services, we network with physicians to develop and coordinate local and national physician advocacy efforts.
Call us at 866-434-6428 or email us.
