Pricing and Market Access Strategy for New Immunology Therapy

Situation

  • Developed pricing strategy for a therapy entering a crowded market.
  • Required a clear view of how the evidence package, expected clinical outcomes, and HTA assessments would shape pricing flexibility and access.
  • Pricing complexity was heightened by multiple doses, titration patterns, and indications across multiple therapeutic areas.

Approach

  • Assessed clinical and HTA outcomes for price and access implications.
  • Built a revenue model to define price thresholds by market, balancing broad coverage and minimal restrictions with WAC.
  • Estimated required rebate levels to support target access outcomes.
  • Developed a competitive landscape of comparator products, including utilization, market share, and cost dynamics, to model expected share capture.
  • Designed a complex utilization-based rebate approach to account for varying doses, titration patterns, and cross-indication pricing dynamics.

Outcome

  • Defined a market-specific pricing strategy to optimize access while preserving value.
  • Quantified rebate expectations and pricing thresholds needed to support payer coverage goals.
  • Built a more realistic view of competitive share capture in a crowded market.
  • Supported decision-making for a complex, multi-indication pricing and contracting strategy.