The Role of Actuarial Science in US Manufacturers’ Potential Budget Impact and Cost-Effectiveness Value Propositions
Author(s)
David Williams, BA, Milliman, Windsor, CT, USA and Tracy Margiott, FSA, MAAA, Milliman, Windsor, CT, USA
Presentation Documents
The objective of this session is to introduce how actuarial modeling capabilities join with clinical knowledge to bring a unique and valuable perspective. Drug and device manufacturers must work within a complex reimbursement / payment structure in the US for their products. Our discussion will focus on the following topics (average 15min each), and conclude with an open question-and-answer period (10min): (1) Patient population modeling, or how actuarial science using real-world data can be used to organize cost models that estimate the disease burden and cost implications for a manufacturer’s various customer types. (2) Pricing strategy considerations, a) including how actuarial science can help stakeholders understand the impact of complex pricing structures such as rebates on various payers (Medicare, Medicaid, commercial, pharmacy benefit manager, employer), b) how alternative contracting methods such as risk-based contracts or value-based pricing are valued, and c) how regulatory and customer willingness factors impact pricing and budgets. (3) Product launch support, such as how actuarial science can be used to estimate profitability of patients taking / using intervention for payer value proposition and compare across various customer types This session will benefit drug and device manufacturers at the foundational and intermediate level.
Conference/Value in Health Info
2022-05, ISPOR 2022, Washington, DC, USA
Code
305
Topic
Economic Evaluation, Health Policy & Regulatory