Introducing new Archbow team member, Meghan Mullooly
In today’s marketplace, provider-administered outpatient drugs that employ a buy-and-bill (B&B) mechanism for reimbursement are widespread. Oncology medications are the largest share of this category, but other specialties like rheumatology, dermatology, and neurology also have many products which fall into the B&B category.
In the B&B process, a healthcare provider purchases, stores, and then administers the product to a patient before submitting a claim for reimbursement to a third-party payer. That creates operational considerations and some financial risk for HCPs. While pharma and biotech manufacturers cannot legally eliminate all risk, well-designed manufacturer programs can help mitigate HCP risk for B&B products.
When manufacturers are planning the launch of a B&B product, there are certain steps that are imperative to include in the launch strategy and development of support services.
We asked new Archbow team member, Meghan Mullooly, to share her expertise in how to successfully build a B&B support program. Meghan has 10+ years’ experience in building, supporting, and growing reimbursement HUB and patient support programs. She’s managed several B&B products through launch, growth, and transition periods, and at one time, led a team of 300 across six distinct brands.
Five Steps to Successfully Support Buy-and-Bill Products, by Meghan Mullooly
1. Provide proactive education and outreach immediately. Deploying a Field Reimbursement Management team to work with HCPs as early as possible will ensure the HCPs know what resources are available and how to properly bill for your product from the start. Waiting until access issues present delays the education that could have helped HCPs avoid access challenges and discourages future utilization of the drug.
2. Determine the level of support you want to provide. The best, holistic approaches consider not only product support needs but also the support associated with product administration procedures. Keep in mind the barriers your patients and HCPs could face based on the B&B familiarity of the specialists and the complexity of the treatment regimen.
3. Develop coding and billing support and resources. Depending on the specialty and familiarity with B&B products, HCPs may require information and assistance billing for unspecified codes. Therefore, coding and billing resources should be integrated into your solution.
4. Provide robust claims support services. Inevitably, HCPs will experience denied or underpaid claims – often due to administrative errors. While manufacturers have a range of legal comfort zones, providing as much support as your legal team permits to facilitate rejected claims support with HCPs can help reverse denied claims and will reduce HCP frustration.
5. Partner with proven experts in reimbursement. Established experience in the B&B space is critical for those who will be communicating directly and indirectly with your customer base. Choose vendors and consulting partners wisely, ensuring they have demonstrated experience and an established track record launching B&B products.
Building and launching a B&B HUB is not something you have to do alone. Let Archbow’s experience supporting B&B products across multiple disease states and HCP specialties streamline your approach and execution. Contact us today to get started and follow us on LinkedIn to get more tips on commercialization support.
Watch this Fierce Biotech webinar on Navigating HUB Design in 2020 to learn more about which HUB model is the right fit for your product.