Program Overview
In a global pharmaceutical landscape shaped by evolving reimbursement systems, regulatory pressures, and value-based care models, pricing decisions determine not just profitability but patient access and long-term sustainability. This program unpacks the complex interplay between pricing strategy, reimbursement frameworks, and financial modeling across the drug life cycle — from launch to loss of exclusivity. Participants will explore how leading pharma companies structure discounts, navigate payer negotiations, and forecast revenue under uncertain market and regulatory conditions. Using real-world cases and modeling simulations, the course enables professionals to design compliant, data-driven, and value-optimized pricing strategies that align business viability with public health imperatives.
Features
- Apply advanced financial modeling techniques to evaluate pricing, reimbursement, and discounting strategies
- Understand the regulatory impacts on pricing and reimbursement decisions
- Design comprehensive pricing strategies that maximize the life-cycle value of pharma products
- Implement sensitivity analysis to assess financial outcomes and risks across drug life cycles
Target audiences
- Finance Teams and Analysts
- Pricing Strategy & Market Research Professionals
- R&D & Innovation Departments
- Clinical & Regulatory Affairs Teams
- Sustainability & Business Transformation Executives
Curriculum
- 6 Sections
- 35 Lessons
- 1 Day
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- Introduction to Drug Pricing and Reimbursement Models6
- 1.1Pricing strategies: Cost-plus, value-based, market-based
- 1.2Regulatory environment, market access, health technology assessments (HTAs)
- 1.3Reimbursement models: payer negotiations, price negotiations, drug formulary inclusion
- 1.4Discounting: rebates, off-invoice discounts, volume-based discounting
- 1.5Economic evaluation frameworks: cost-effectiveness, cost-utility analysis
- 1.6Quick diagnostic: Assess current drug pricing and reimbursement strategy and identify improvement opportunities
- Financial Modeling of Life-Cycle Value8
- 2.1Life-cycle value analysis (LCVA) for drugs
- 2.2Projecting revenue streams from launch to end-of-patent
- 2.3Accounting for pricing erosion, generic entry, and market expansion
- 2.4Impact of regulatory changes and market access strategies on revenue forecasting
- 2.5Discounted cash flow (DCF) models for pharma products
- 2.6Integrating pricing elasticity and payer behavior into long-term forecasts
- 2.7Case Example: Novartis’ launch of Kymriah – designing a life-cycle financial model for a gene therapy with complex reimbursement structures
- 2.8Exercise: Build a basic life-cycle value model for a new drug, factoring in initial launch price, price erosion, and reimbursement schedules
- Pricing Strategy, Discounting, and Market Access7
- 3.1Structuring rebates and discounts to balance market share and profitability
- 3.2Negotiating with payers, PBMs (pharmacy benefit managers), and government agencies
- 3.3Implementing access programs – Patient Assistance Programs (PAPs), co-pay assistance
- 3.4Designing tiered pricing models for different markets (e.g., emerging markets, tiered pricing in Europe)
- 3.5Assessing the financial impact of value-based agreements (VBAs) and risk-sharing agreements
- 3.6Example: Pfizer’s pricing strategies for new oncology therapies in the U.S. and Sanofi’s market access in emerging markets
- 3.7Exercise: Develop a pricing and discounting strategy for a new product considering payer negotiation constraints and market access hurdles
- Assessing the Impact of Regulation and Policy on Pricing and Reimbursement7
- 4.1Regulatory influences on drug pricing (e.g., price controls, patent laws, compulsory licensing)
- 4.2Impact of global HTA guidelines and national reimbursement policies
- 4.3Managing cost containment measures in public health systems
- 4.4Market access barriers: The role of local pricing policies in international markets
- 4.5Adapting pricing models to Medicare, Medicaid, and private insurance system
- 4.6Case based learning: European Union pricing control impact on the launch of Gilead’s Sovaldi for hepatitis C treatment
- 4.7Case study Analysis: Evaluate the impact of a global regulatory framework on a drug’s pricing and reimbursement strategy in key markets
- Advanced Discounting, Risk Adjustments, and Sensitivity Analysis5
- 5.1Risk-adjusted pricing models for uncertain reimbursement conditions
- 5.2Discounting cash flows in the context of uncertainty and payer behavior
- 5.3Applying sensitivity analysis to pricing and reimbursement models
- 5.4Evaluating net present value (NPV) and internal rate of return (IRR) in the presence of regulatory risks
- 5.5Simulate a pricing and reimbursement scenario for a drug under different discounting and risk conditions, applying sensitivity analysis to assess financial viability
- Pricing Strategy Roadmap2
- 6.1Pricing Strategy Challenge- Develop a pricing and reimbursement strategy roadmap for a new drug, considering regulatory, market access, and financial modeling constraints
- 6.2Deliverables: Proposed pricing structure, Discounting strategy and rebate framework, Risk mitigation and regulatory alignment plan
Instructor
