Strategic Evaluation of Reimbursement Pathways in Orphan Drugs for Duchenne Muscular Dystrophy

CHALLENGE

Our client, a leading life sciences consultancy firm, aimed to assess the reimbursement potential and pricing strategies for a new preclinical drug candidate for Duchenne Muscular Dystrophy (DMD) in the United States. The objective was to gain insights into potential reimbursement pathways, including Medicare, Medicaid, and private insurance options, and to evaluate the drug’s market potential based on current and future payer perspectives.

BTHT APPROACH

To address our client’s needs, BTHT team promptly started the searching process to find the most relevant professionals in the US. Our research team prepared a portfolio of experts including:

- Payers, who have deep expertise in evaluating drug reimbursement potential and pricing strategies, particularly in the context of orphan drugs and rare diseases. - Healthcare Reimbursement Specialists, knowledgeable about Medicare, Medicaid, and private insurance frameworks, capable of providing insights into potential reimbursement scenarios.

BTHT team organized and facilitated one-hour consultations with a specialized payer expert in the U.S. During the consultation, the expert reviewed the current landscape of available treatments for DMD, discussed the target product profile of the candidate drug, and explored reimbursement possibilities with the client.

OUTCOME

The expert provided valuable insights into the reimbursement and pricing landscape for the candidate drug. The consultation highlighted key aspects such as current reimbursement practices, possible obstacles, and strategic opportunities within Medicare, Medicaid, and private insurance systems.

Armed with this expert feedback, the consultancy firm was equipped to guide their client in navigating the complex reimbursement environment, optimizing strategies for market entry, and enhancing the potential for successful drug adoption in the U.S.