EMC Lifeline

 IS THIS YOUR REALITY?

 

  • Your sales team must continue to be better at delivering increased brand sales with today’s existing formulary access.

 

  • Your sales team has an opportunity to be more effective making your brand(s) the solution for providers, their staff and the patients they serve whether they be Commercial, Part D, LIS, Medicaid, or Exchange patients.  

 

  • You are seeing more “Closed and Limited” drug formularies which that means the patient is less likely to get the brand Rx your sales representative generated finally written by their provider, unless of course, they are willing to do “medical necessity” submission with no guarantees. 

 

  • The contracted T2 position that you pay a high double digit discount/rebate on to the plan or PBM  is not performing any better than many or some of your T3 competitors. You notice you have T3 positions at some plans that are exceeding your own brand’s T2 performance in the same market.

 

  • ACOs are focused on improving their CMS Quality Score Cards and P4P programs in your disease arena. Your organization needs to be part of that equation beyond a sales representative operating from a number of angles.

 

Brace yourself as there is more complexity and pressure to come with the these developments.

 

  • Employers with rich insurance benefits packages are planning now for how they will avoid  the 40% “Cadillac “ excise tax in 2018 for premiums paid by insured and self- insured employers exceeding $10,200 for individual premiums or $27,500 for family premiums.  This means more patient “out of pocket" expenses.

 

  • PBMS are now beginning to work directly with ACOs.

 

  • Private Exchanges, which we don’t talk about now because they mirror the carrier’s current formulary, should hit $40 million patient enrollees by 2018 at about the same time the Cadillac tax goes into effect.

 

  • In 2006, only 4% of consumes had high-deductible health plans. In 2013, 20% of US residents had high deductible health plans, and the trend continues to grow. 

 

  • Industry success in gaining FDA approvals for many high cost specialty drugs will no doubt continue.

 

 

Through EMC-Lifeline, Simon Leads will partner with your company to generate creative solutions!

 

Executive Managed Care Lifeline  (EMC-Lifeline)

Inquire about a 6 or 12-month retainer for an Executive 1:1 Managed Care Consultant  for as low as $4K a month.  This investment could easily translate to an ROI of $10 to 100 thousand in sales upside via improved managed markets strategy and/or field force execution on today’s brands and today’s current formulary access depending on the brand’s situation in  Commercial, Part D, LIS, Medicaid and or Exchange channels. 

 

Simon Leads has over 15 years of success in managed markets negotiations, contracting, C-Suite exchanges, and sales force brand market execution.  Our experience encompasses the SVP, VP, and Director levels leading Managed Markets in most therapeutic areas including oncology, diabetes, infectious disease, pain, cardiovascular, central nervous system, women’s health, and dermatology.  Simon Leads offers innovative solutions that stem from insider-industry knowledge.

Certified Hudson Institute Coach  

(Accredited Coach Training Program by ICF)

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