Book contents
- Commercializing Successful Biomedical Technologies
- Commercializing Successful Biomedical Technologies
- Copyright page
- Dedication
- Contents
- Preface
- Acknowledgments
- 1 The biomedical device and drug industry and their markets
- 2 Markets of interest and market research steps
- 3 Starting up your company
- 4 Intellectual property and licensing
- 5 New product development (NPD)
- 6 The regulated market: gateway through the FDA
- 7 Manufacturing
- 8 Reimbursement, marketing, sales, and product liability
- Glossary
- Index
- References
8 - Reimbursement, marketing, sales, and product liability
Published online by Cambridge University Press: 03 November 2022
Book contents
- Commercializing Successful Biomedical Technologies
- Commercializing Successful Biomedical Technologies
- Copyright page
- Dedication
- Contents
- Preface
- Acknowledgments
- 1 The biomedical device and drug industry and their markets
- 2 Markets of interest and market research steps
- 3 Starting up your company
- 4 Intellectual property and licensing
- 5 New product development (NPD)
- 6 The regulated market: gateway through the FDA
- 7 Manufacturing
- 8 Reimbursement, marketing, sales, and product liability
- Glossary
- Index
- References
Summary
This chapter simplifies the complex multi-payer healthcare reimbursement market and explains how to position your product for successful reimbursement. The best time to bring reimbursement planning into the product development process is discussed here. The U.S. healthcare system is used as a baseline and the healthcare systems of other countries are reviewed briefly. Reimbursement for devices and administered drugs is based on many factors, and this chapter shows the steps a biomedical product company can take to maximize revenues in the US Healthcare system. The basics of reimbursement – coverage, coding, and payment – are explained in simple terms with diagrams. Case studies help show how individual companies have addressed the reimbursement process for novel breakthrough technologies.
Keywords
CMMSmedicareMedicaidinsurancePBMpharmacy benegit managerformularycodingpaymentcoverageclinicalhealth careCPTDRGdiagnosis related groupCLIAcost-effectivereal-world dataclinical outcomeshealth economicsICERNICEpharmacoeconomicsHCPCSAmerican Medical AssociationICD-11ICD-10IPPSOPPSAPCphsyician fee schedulePLA codesADLTPAMACLFSASPcross-walkingstacked codegap-fillreimbursement planningmarket adoptionKOLsalesMSL medical science liasonliabilityproductnegligencewarranty
Information
- Type
- Chapter
- Information
- Commercializing Successful Biomedical Technologies , pp. 363 - 419Publisher: Cambridge University PressPrint publication year: 2022
References
References and additional readings
Atkins, N, and Bohmer, R. (2000). Aspect Medical Systems. Case Study no. 9-600-076. Cambridge, MA: Harvard Business School Publishing.Google Scholar
Auxter, S. (2000). Marketing diagnostic tests directly to the consumer. Clinical Laboratory News 26(4), 4.Google Scholar
Campbell, J. (2005). Understanding Pharma. Raleigh, NC: Pharmaceutical Institute. ISBN 0-9763096-0-2Google Scholar
Drummond, MF, Sculpher, MJ, Torrance, GW, O’Brien, BJ, and Stoddart, GL. (2005). Methods for the economic evaluation of health care programmes. Third edition. Oxford: Oxford University Press. ISBN: 0-19-852945-7Google Scholar
Folland, S, Goodman, A, and Stano, M. (editors). (2007). Economics of Health and Health Care. Upper Sadle River, NJ: Prentice Hall Publishing. ISBN: 0132279428Google Scholar
Harris, G. (2004, January 30). US weighs not paying for all uses of some drugs. New York Times.Google Scholar
Kerr, NF, and Recupero, T. (2015). Product Launch: Practical Guide to Launching Medical Device Products. Kerr Consulting Group LLC. ISBN: 978-0990908104Google Scholar
Ohsfeldt, RL, and Schneider, JE. (2006). The Business of Health: The Role of Competition, Markets, and Regulation. AEI Press. ISBN: 0-8447-4240-6Google Scholar
Pekarsky, BAK. (2015). The New Drug Reimbursement Game: A Regulator’s Guide to Playing and Winning. Adis/Springer International Publishing. ISBN: 978-3-319-34920-6Google Scholar
Phelps, CE. (2003). Health Economics, 3rd ed. Reading, MA: Addison-Wesley, 2003. ISBN-13: 978-0321068989Google Scholar
Pizzi, LT, (2016). The Institute for Clinical and Economic Review and its growing influence on the US healthcare. American Health & Drug Benefits 9(1), 9–10.Google ScholarPubMed
Provines, CD. (2012). Strategic Pricing for Medical Technologies: A Practical Guide to Pricing Medical Devices & Diagnostics. Christopher D Provines. ISBN: 978-0615661896Google Scholar
Shiroiwa, T, Fukuda, T, Ikeda, S, et al. (2017). Development of an official guideline for the economic evaluation of drugs/medical devices in Japan. Value in Health 20(3), 372–378.CrossRefGoogle ScholarPubMed
Walker, TP. (2018). Insights: 33 Lessons Learned in Medical Device Marketing. Utah: Life Catalyst Publishing. ISBN: 978-0997635829Google Scholar
Walley, T, Haycox, A, and Angela Boland, A. (2004). Pharmacoeconomics. Churchill Livingstone Press. ISBN: 044307240XGoogle Scholar
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