Private payers

The market access environment in Canada has multiple stakeholders, and different strategies are required for public and private payers. The private payer community is varied and includes pharmacy benefit managers, health benefit consultants, and private insurers. In Canada, the private sector makes up greater than half of prescription drug purchases.

Over the years the world of prescription drugs has changed tremendously in Canada. We see more highly specialized therapeutics, for patients with increasing unmet need, and more treatments are being administered outside the hospital setting.

Private payers are a critical part of the market access landscape in Canada and are essential to the success of a new prescription drug launch. With different needs and criteria for reimbursement, a dedicated strategic plan is necessary in order to optimize reimbursement for this large market in Canada.

IMAC has extensive market access experience and a dedicated private payer specialist with decades of industry experience working with Canadian private payers. Our considerable experience informs our strategy for successful reimbursement submissions tailored to the specific requirements and needs of this diverse but important group.

Some recent examples:

  • A pioneering strategy for private payer economic models for a first Health Canada approved therapeutic for Peyronie’s disease—despite a lack of data comparing the cost and healthcare resource utilization with the standard of care (surgery).

  • Private payer models and submissions for a first and only single-dose IV antibiotic for the treatment of acute bacterial skin and skin structure infections.

How can we help you?

Contact us at one of our International offices or submit a business inquiry online.

Yulia specializes in systematic literature reviews, pharmacoeconomic analyses, and outcomes research.

Yulia Vadziuk
Yulia Vadziuk
Senior Consultant, Health Economics

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