CASE STUDY

Development of reimbursement dossier featuring clinical and economic data (including Canadian real world data)

Situation

Our client had a request from clinicians for assistance to develop a reimbursement submission dossier for an innovative technology. Since the new technology was more expensive than what was currently used, a key element of this submission would be a linking the clinical benefits with savings and sustainability.

Diagnosis

The submission dossier required a review of clinical and economic benefits from peer reviewed references and a correlation to Canadian process and costs using real world data to generate projected costs and savings.

Solution

Research was conducted to enhance understanding of challenges and develop a working model that was used to develop a discussion guide. Clinicians, administrators, and government agencies were interviewed, provided information on challenges with current products, benefits of the new technology, and volumes and costs related to patient visits/testing/interventions. A submission dossier was prepared that explained the clinical and economic benefits, budget impact/savings analysis with links to healthcare sustainability.

Result

The client, clinicians, and administrators were pleased with the document and used the submission to apply for additional funding for the new technology.

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