Health Economics & Reimbursement Strategy
For more information, reach out to our Innovator Support Lead:
Dr. Julia Berzhanskaya
Dr. Arnold helps innovators understand health economics considerations:
- How much does an episode of care currently cost?
- What impact will your product/service have on this figure?
- How do you plan to quantify the improvement in health outcomes purported by use of your product/service?
- Resource use, improved quality of life (QoL), length of stay (LOS), etc.
- If there is a QoL aspect, do you plan to use it for an indication?
- What is/are your health economic endpoint(s) with different stake-holders?
- e.g., Cost avoidance, cost savings, cost-effectiveness
- What/who will be the focus/foci of your sales pitch?
- Will the buyers be users and/or sales influencers, e.g., hospital administrators, KOLs?
- Do you plan to try for reimbursement from non-U.S. countries' health technology authorities? If so, how?
Dr. Arnold has an expertise on following important health reimbursement considerations:
- What entity(es) will be the buyers of your product/service? (Hospitals, pharmacies, physicians, patients, other)
- How will the buyer fund (or be reimbursed for) this purchase?
- Line-item reimbursement from insurers: Do insurers' coverage policies exist? Do appropriate reimbursement code(s) already exist? If yes, how much do they pay? If no, what is the plan for seeking new codes?
- Part of a global payment, e.g., a non-line-item payment system like Medicare DRGs or APGs
- Cash payment by the patient
- Does your product/service fit within an integrated delivery systems (e.g., Kaiser Permanente, VA) and ex-US payment systems?
About Renée
Dr. Arnold is currently President & CEO, Arnold Consultancy & Technology, LLC, where she oversees outcomes research and develops affiliated software for pharmaceutical and government programs. Her special interest in evidence-based health derives from her research that deals with use of technology to collect and/or model real-world data for use in rational decision-making by healthcare practitioners and policy makers. Renée is also Adjunct Professor, Master of Public Health program, Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, New York, New York, where she has developed and teaches the pharmacoeconomics coursework. Renée completed her undergraduate training at the University of Maryland and received her Doctor of Pharmacy degree from the University of Southern California in Los Angeles. She also completed a post-doctoral residency at University Hospital in San Diego/University of California at San Francisco School of Pharmacy.