Building Payer Coverage: C-E Models and Value Dossiers
[Circassia]The client’s technology (NIOX) could be utilized in a number of ways as an aid to asthma diagnosis and asthma treatment. Coverage of the technology, however, was only on a case-by-case basis; the client needed to build broader coverage of the technology. Asthma is too broad of an indication for blanket coverage; the client needed to prioritize market segments and use cases. TTi proposed mining Circassia’s data to identify “stories” and value propositions that could be built. From this work, TTi & Circassia identified 4 distinct use cases for NIOX in which value could be clearly demonstrated. Four C-E models and a comprehensive payer perspective value dossier were developed. Additional communication pieces, including peer-reviewed journal articles, interactive models, and KOL training materials were developed. The client was able to demonstrate and communicate the value of their technology to payers, resulting in increased payer coverage.
https://journal.chestnet.org/article/S0012-3692(17)31566-0/fulltext
https://pubmed.ncbi.nlm.nih.gov/29989900/
https://pubmed.ncbi.nlm.nih.gov/29989901/
https://www.annallergy.org/article/S1081-1206(17)31015-3/fulltext
Our contract payer relations team told us that these were the best CE tools they’d ever worked with. Within several months we saw a significant increase in the establishment of favorable coverage policies.