Payor Marketing and Health Plan Account Leads
Agency Partner: The Kinetix Group
Boehringer Ingelheim Team Members:
- Freddy Quinchia, Director, Payor Access Marketing
- Jess Rubin, Senior Associate Director, Payor Access Marketing
- Stephanie Delman, Campaign Marketer, Payor Access Marketing
- Lillian Alibaruho, Senior Associate Director, Payor Access Marketing
- Jeff Puckett, Market Access, Contract Development and Analytics
- Steve Sander, Director, Pricing and Contracting Strategy
- Sharash Shetty, Therapeutic Area Director, HEOR, Metabolism
- Jim Hunsicker, Director, Payor Solutions Marketing
- John Joyce, Senior Associate Director, Payor Solutions Marketing
- Leo Seman, Director, Medical Affairs
- Mike Rausch, Area Director
- Susan Young, Regional Account Executive
Today’s payor marketing teams have to deal with an environment at a crossroads. The U.S. payor access decision-making model is shifting from fee-for-service to a value-based care delivery network. However, while all payors are directionally evolving towards a value-based care model, they are at various points in moving towards this goal.
Additionally, value-based contracts (VBCs) aren’t just a more complicated type of contract, but most also require a tremendous amount of data and analysis to understand the translation of clinical and/or financial outcomes. And in the end, they still must be simple enough to understand, execute, and monitor.
The Payor Marketing and Health Plan Account Leads at Boehringer Ingelheim were tasked with developing an innovative solution to address the growing hyper-competition and commoditization in the diabetes market which continues to fuel rebate pressures, erode gross-to-net, and impact access. This required a dedicated team to reframe value in the context of meaningful quality outcomes and lower cost of care by designing and executing a VBC that could demonstrate an annual total cost of care savings to payors.
Becoming the Class of VBCs
For Boehringer Ingelheim to be seen as a partner in the payor marketplace, the team first established a set of operational principles that would address key execution challenges frequently voiced by payor customers.
The team then designed two phases of the Jardiance VBC solution and developed a seamless narrative that articulates the total value of Jardiance. Through a retrospective claims database analysis, the team was able to quantify the superior reduction in the total cost of care for Jardiance versus competitors (generic and branded) of approximately $13,704—driven by significant medical cost reductions. They provided payors with value translation resources so the payors could use their own medical and pharmacy claims to replicate the total cost of care analysis.
An Innovative VBC Design
Backed by their belief in the clinical benefits of Jardiance, and after conducting the total cost of care analysis on their population, the University of Pittsburgh Medical Center (UPMC) Health Plan negotiated an innovative VBC with the team that includes targeted data-driven payor-induced outreach communications to providers and members.
This innovative VBC design accelerated successful execution with other VBCs in market and access to Jardiance, and speaks to Boehringer Ingelheim’s efforts to advance development of innovative medicines in diabetes that improve the lives of patients and their families.