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Case Study 1

Business Type: 
Division of Top 10 Pharmaceutical Company
Functional Area: 
Pricing Policy and Analytics for Managed Care

Historically, Managed Care Pricing decisions were made based on highly subjective information and emotion; not "fact based" on historic customer and contract performance. Part of the reason was that data was so limited and inaccurate that often the customer was contacted to "see how are we doing." As a result, members of the Pricing Committee realized that this environment was leading to substantial inefficiencies and marginal rebate investments with their managed care customers. PharmaMetrics was brought in to help integrate managed care data and optimize their rebate investments.

Business Challenges: 
  • Due to the fact that there was no rebate system in place, all utilization and market share data had to be pulled and loaded from separate Excel worksheets.
  • Prior administrations had taken a very aggressive pricing stance; any changes would most likely result in push back from the customer.
  • The organization was very "silo" based, which slowed down the decision-making process and buy-in of any new pricing concepts.

PharmaMetrics helped the organization to analyze approximately two years of data for their dominant brand, over twelve strategic PBMs and/or HMOs within the managed care market. We were given imperfect internal data from the Excel worksheets and manually loaded it into our business tool - Analysis of 3rd party claims data served as a second validation that there were changes that needed to be made. Once the business parameters were defined, key accounts were then prioritized based on business variables, not "emotion".


By implementing PharmaMetrics "Rational Pricing" methodology, the company was able to identify accounts that were underperforming from a market share/ rebate investment perspective. The organization also consulted with PharmaMetrics and developed "best practice" structures resulting in a more manageable, efficient contact decision-making process.

  • New Standard Operating Procedures for managed care pricing were developed and implemented by the Pricing Committee.
  • The organization was able to reduce its average discount percentage by just less than 5.0 discount points, over approximately a three year period, the with marginal to no impact on market share performance.
  •  “What sets PharmaMetrics apart is the depth and breadth of their true business knowledge.”
            -- Director, Contracts, Top 20 Pharma

  • “PharmaMetrics solutions can either be a complete business solution or independent modules that supplement your current business infrastructure.”
            -- Director, Contracts, Top 20 Pharma

  • “The implementation was easy and I didn’t need any training whatsoever. If you know how to do your job – the system follows your process. You don’t have to change your process to meet the systems needs.”
                -- Director, Corporate Compliance, Dermatological Company

  • “The industry experience and knowledge of their expanded team of experts sets them far apart from other service providers within the industry.”
                -- Director of Contracting, Amarin Pharma Inc.

  • “PharmaMetrics offers the services and software to handle all of our Managed Markets needs from front-end pricing analytics to the ban-end contract administration.”
            -- Sr. Director, Contract Management, Top 10 Pharma

  • “The robust reports generated enable more accurate forecasting and financial analysis.”
            -- Sr. Director, Top 10 Pharma