Our Formulary & Reimbursement Execution service provides hands-on support for formulary submissions, rebate strategy, and PBM negotiations. We help you navigate the complex formulary process, from submission preparation to PBM committee presentations.
How our formulary & reimbursement execution service delivers value to your organization.
Comprehensive formulary submission preparation including clinical evidence, economic justification, and comparator analysis.
Rebate and discount strategy development with PBM-specific modeling and competitive rebate analysis.
Direct negotiation support with PBMs including Express Scripts, CVS Caremark, and OptumRx.
Ongoing monitoring of formulary status, tier changes, and competitor formulary wins.
Comprehensive deliverables that provide actionable intelligence for your team.
A structured methodology that delivers results in four phases.
Prepare formulary submission with clinical evidence, economic model, and comparator analysis.
Develop rebate strategy with PBM-specific modeling and competitive positioning.
Support PBM negotiations including presentation, rebate negotiation, and contract terms.
Monitor formulary status and track competitor formulary changes.
We have experience negotiating with all major PBMs including Express Scripts, CVS Caremark, OptumRx, Humana Pharmacy Solutions, and regional PBMs.
We analyze competitor rebate positions, PBM formulary structure, covered population, clinical differentiation, and budget impact to determine optimal rebate levels.
Yes, we support Medicare Part D formulary submissions including PDE data analysis, star rating implications, and CMS compliance requirements.
Value dossier preparation, payer engagement execution, and negotiation coaching for market access success.
Learn moreBudget impact models, cost-effectiveness analysis, and ROI frameworks for pharmaceutical market access.
Learn moreRWE study design, data source identification, and evidence generation plans for market access and regulatory support.
Learn moreConnect with our team to discuss how our formulary & reimbursement execution service can support your goals.
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