Reimbursement Threshold Analysis
Health economic analysis from phase 0 to the post market surveillance
Knowing the reimbursement potential is probably something different than knowing the usual business prospect and market potential. Reimbursement potential of a device essentially depends more on country or region specific decision making process rather than the novelty of the intervention alone.
Reimbursement decision is always complex and comparative. Local decision makers are keen to get local clinical and economic data analyzed by a recommended methodology. To make a positive decision, a new device’s performance is usually compared with the existing options and the classical measure is Incremental Cost Effectiveness Ratio (ICER). To be in the positive list, your product should always be below the cost effectiveness threshold, which means a reasonably lower ICER or cost per outcome than the comparator. So, knowing your products’ prospective ICER or reimbursement threshold can be an important part to formulate the business strategy.
An early phase economic evaluation can provide your products prospective ICER, whether it is below or above the reimbursement threshold. Sometimes this analysis is called as threshold analysis or just to know your threshold. Threshold analysis can provide you information that can be integral for your products business strategy:
- What can be the maximum possible price keeping the ICER below the cost effectiveness threshold?
- What are the clinical parameters that can make your ICER acceptable to be reimbursed?
Synergus early economic model can help you to calculate / predict the probable pricing for a target reimbursement threshold. This analysis can also provide the conclusion about the most sensitive clinical and economic parameters that can drive your reimbursement potentials.