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Expert Interview

Slingshot members are talking to an expert! The topic is:

Discussing private and commercial payer reimbursement strategies in the US for Pfizer's Paxlovid with a billing expert who interacts with pharmaceutical companies related to COVID-19 treatment.

Ticker(s): PFE

Who's the expert?

Insitution: AllWays Health Partners

  • Billing expert with an MBA and strong background in Healthcare Finance
  • Has held various positions as a senior financial analyst in most of the leading healthcare providers and insurance companies.
  • Expert in implementing code editing software ClaimsXten, Change HealthCare, Covid19 reimbursement, healthcare reimbursement, both commercial and medicaid, and Federal Regulatory Alignment in pricing and transparency.

Interview Questions

In your opinion, how are U.S. private/commercial payers approaching reimbursement of PAXLOVID? For example, are they considering reimbursement broadly or for specific patient groups, such as age, co-morbidities, and/or disease severity?

Added By: pharmaadvisor

How are payers evaluating reimbursement levels with the manufacturer?  Do payers expect that the contracted price for PAXLOVID will be higher or lower than the current price paid by US HHS?

Added By: pharmaadvisor

When do you believe that commercial payers will begin adding PAXLOVID to their formularies?

Added By: pharmaadvisor

Are commercial payers evaluating the use of value-based contracting for PAXLOVID? If so, what would you expect the metrics to include?

Added By: pharmaadvisor

As someone that represents a payer, what evidence is important that the manufacturer demonstrates that PAXLOVID has a meaningful impact on their patient population? Does this include clinical evidence? Inclusion of real-world evidence?

Added By: pharmaadvisor

What insights is it important to you that the manufacturer shares for your organization to consider a broader PAXLOVID reimbursement strategy? Should they include RWE, clinical insights, and key opinion leader content? What is important that they share that would highlight the economic value of PAXLOVID?

Added By: pharmaadvisor

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