Pricing & Access

Trinity supports pricing strategy at all phases of development to support a product’s access and commercial success, including pre-clinical prioritization, launch pricing and lifecycle management.  

A nuanced understanding of Pricing & Access issues is needed to support other types of work, including Strategic Advisory offerings (e.g., corporate strategy, strategic product planning and business development support), and Commercial Analytics (e.g., forecasting). 

Trinity has extensive experience working with cross-functional decision makers to provide a detailed understanding of how Pricing & Access dynamics, such as gross price, net price, reimbursement policy and emerging marketplace developments impact commercial success.

Pricing Offerings

• Contract Analytics

  Constructing and evolving contracting strategy is challenging. There are many scenarios and variables to evaluate when establishing the placement and targeting of contract value and investment. Each option requires unique inputs and models—and each scenario has a range of potential impacts on stakeholders, from internal finance teams to payers and providers.

  Contracts have both direct and indirect impacts on ASP (Average Sales Price), Reimbursement, 340B price and Medicaid rebates. Each of these elements could then impact product demand, net revenue, net price per unit and breakeven ROI contract targets—with the indirect costs having greater impact than direct contracting costs in certain situations.

  The central question is how to quickly evaluate and quantify the holistic impact of contracting decisions to arrive at the optimal contract strategy and avoid making mistakes that cannot be rectified down the line.

  Crafting impactful contract strategy requires expertise in life sciences and deep U.S. payer, provider, government policy, regulatory, distribution and finance knowledge.

  Trinity’s Contract Analytics offering provides advisory services powered by Trinity CloudCast™, a cloud-based modeling and analytics tool.

  Clients are able to:

  • Establish confident contract and price change strategies with full understanding of the financial impact on payers, providers and all other stakeholders (wholesalers, GPO, etc.)
  • Support contract negotiations and identify negotiating boundaries and breakeven points to mitigate the risk of accepting unfavorable and/or unprofitable contracts
  • Protect market share from new or competing drugs and impact prescribing levels across an asset’s life cycle
  • Enter a highly contracted market with precise pricing and contract strategies aligned to and customized for the relevant distribution channels and market segments
  • Proactively and painlessly incorporate competitive and market events—as well as proposed or approved policy changes—into contracting strategy

  Clients navigate U.S. pricing, contracting, provider economics and Gross-To-Net (GTN) decision-making by understanding the impact of individual contract strategies through expertly curated insights, unlimited scenario analysis (unlimited number of contracts and channel types) and accurate, comprehensive financial forecasting/modeling.

  The contracting process is streamlined by forecasting the impact of changes in Wholesale Acquisition Cost (WAC) and other contracting elements including GTN, Average Sales Price (ASP), 340B and Medicaid considerations.

  Contract Analytics integrates with Trinity’s Payer/Pricing Strategy, Contracting Strategy, Forecasting and Payer Analytics offerings to provide cross-functional support, establish KPIs to track ROI and evaluate risk across an asset’s market access journey.

  

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• Payer/Pricing Strategy

  Trinity helps brands to maximize their place in the market by developing and pressure testing pricing plans and gathering or generating strong supporting evidence. We offer a complete solution, from a high-level strategic pricing plan all the way to detailed tactics about specific discounts and offer structures. 

  Our clients benefit from leveraging Trinity’s quality global research panel, giving us a unique ability to gather nuanced insights about pricing specifics for each country or payer type on a peer-to-peer level. 

  Each year we conduct pricing research with a wide range of customer types, including:  

  • National, regional, and local pricing authorities, hospital payers, and health technology assessment (HTA) bodies across global markets 
  • U.S. payers including Commercial (MCOs, IDNs, PBMs), Medicare (Advantage, PDP, and ex-MACs), Medicaid (state FFS and managed), and other (VA, employer groups, etc.) 
  • Institutional (hospitals, LTC, etc.) payers, pathway vendors, and reimbursement decision-makers at the provider level 
  • KOLs, HCPs, and other provider staff (administrators, care coordinators) who facilitate access as well as navigate any payment barriers 
  • Patients and patient advocacy representatives 

  Additionally, the features and strategic issues at hand span across a wide range of permutations:  

  • Strategies involving multiple indications and optimal sequencing / bundling strategies 
  • Products with complex administration or packaging / SKU considerations 
  • Innovative pricing, contracting and payment models 
  • Lifecycle list and net price management across channels 
  • International reference pricing and price corridor management 
• Contracting Strategy

  We support clients’ contracting efforts from early assessment to strategy development, execution support and reporting / performance measurement. Trinity’s holistic services include support with contracting and tendering with both U.S. and global payers, as well as U.S. providers. 

  While a large portion of our contracting work can be considered ‘traditional’, we also support clients who are considering innovative contracting approaches, such as outcomes-based or other value-based arrangements. Whatever your need, Trinity’s strategic support is holistic and end to end.

  OUR APPROACH
  Through collaborative working sessions, detailed account data analysis, and robust economic modeling, we can determine the optimal strategy to help our clients overcome value deficiencies.

  Payer Contracting:
  We guide our clients to establish a net price to optimize physician and patient access. Global net price strategies seek to balance price maintenance with access attainment, often considering multiple indications or populations. Meanwhile, U.S. managed care rebate strategies are structured to optimize to formulary positioning and mitigate barriers associated with utilization management.  

  The Trinity Difference:

  • Deep knowledge of competitive markets, as well as ability and experience in establishing relative clinical differentiation and value outside of price concessions and contracting 
  • Robust understanding of the relationship between pricing and evidence, and specifically how that can be applied to innovative contracting strategies (e.g., reducing payer uncertainty through tailored agreements) 
  • Strong relationships and experience with experts representing U.S. managed care organizations including insurance, Pharmacy Benefit Managers (PBMs) and payer Group Purchasing Organizations (GPOs) 

  Provider Contracting Expertise:
  Trinity has a deep understanding of provider economics and how to optimize provider contracting to shape decision-making and ensure access while maintaining value.
  

  The Trinity Difference:

  • We have strong relationships with specialty GPO leadership, as well as multiple top 50 U.S. oncology practices 
  • Our contracting strategy recommendations are based on in-depth analytics 
  • We have the ability to provide follow-on support for contract adjudication and optimization 
  • Trinity’s Contract Analytics guides contract decision-making in the context of implications across all stakeholders: manufacturer, provider, payer/health system, trade and distribution

Access Optimization

The access landscape is changing; cross-border collaborations are forming to better support accelerated access to high-cost and orphan therapies, new policies are in development to address the healthcare disparities that have been highlighted during the COVID-19 pandemic, and innovative pricing and reimbursement approaches are being implemented to ensure the latest advances in healthcare technologies reach growing patient populations globally.

• Access Analyzer

  Access Analyzer provides the ability to track and monitor performance by plan and payer.

  The solution suite offers digitization, proprietary frameworks and algorithms, nearly instant value and in-depth dataset knowledge:

  • Solutions focused on automation, integrated insights and alerts for wide adoption and scalability
  • Proprietary payer/provider evolution models and frameworks to drive push- and pull-through opportunities
  • Cutting-edge technology to integrate access data dynamically from multiple sources and disseminate insights across organizations
  • Deployment-ready, out-of-the-box dashboards and storyboards
  • Automated applications to drive continuous insights
  • Comprehensive expertise across life sciences datasets:
    • Patient-Level Data
    • Formulary Data
    • Sales Data
    • Affiliations Data
    • Patient Support Program Data (HUB & Nurse Support Services)
    • EDI 844, 867 Data Feeds
    • Pricing Data

  Access Analyzer delivers results:

  • 9% Revenue generated incrementally across 10+ payer contract recommendations
  • 16% Increase in approval rates through office support program recommendations
  • 50% Increase in cross-functional team collaboration to leverage and enhance existing solutions

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• Monitoring Access Trends

  Our experts monitor access trends and policy changes to inform landscape assessments and help our clients understand access expectations, including collaboration opportunities to gain early HTA advice to secure better outcomes and nuanced market access timelines by region. 

  The Trinity Difference: 

  • We support our clients with the development of evidence that can support payer needs, including payer-optimized pivotal trial design, supplemental evidence needs and early payer advice 
  • Our experts work cross-functionally or in tandem with KOL and HCP research to understand populations of interest and determine which access barriers would be most problematic to adoption of new therapeutic options 
• Trade & Distribution

  Our experts understand the need for simplicity in supply chain decision-making and management. We help our clients to determine the optimal distribution strategies to reduce time-to-patient, ensure efficiency around arranging distribution to trade partners, and secure cost-effective distribution solutions. 

  The Trinity Difference: 

  • Deep knowledge of specialty distribution and GPOs (oncology and medical benefit products), as well as strong relationships with those stakeholders 
  • Deep understanding of commercialization models in emerging markets and experience working with distributors 
  • Long-standing experience with contract implementation through various trade channels 
  • Experience with trade and distribution contract structures, and a strong understanding of terms to minimize impact on US government pricing metrics 
  • Familiarity and comfort guiding trade and distribution decision-making relative to whole line, wholesale, specialty, and government channels