Focused on the Health Industry

Pharmaceuticals and Biologicals

Pharmaceuticals and Biologicals

McDermottPlus advises some of the world’s largest and most innovative pharmaceutical and biological developers and manufacturers.

Representative Experience

  • Reimbursement consultant to leading global pharmaceutical and biological companies
  • Prepares clinical evidence dossiers to support coverage for new products at launch including a description of the clinical need for the new product, the mechanism of action, summary of clinical evidence, summary of health economic evidence and regulatory status
  • Prepares template reimbursement assistance documents to support the launch of new products pending adoption of new billing codes, including template letters of medical necessity, claim forms, procedure reports and bibliographies
  • Develops a model for a life sciences company to use; with hospital clients to demonstrate the change in payment and costs associated with including their product on the hospital’s formulary
  • Develops a coding, coverage and reimbursement plan for a life sciences company that is to support the launch of a novel treatment option for Parkinson’s Disease patients
  • Successfully obtaining a favorable hospital outpatient department payment rate under Medicare for a procedure that uses a product developed by a life sciences company
  • Analyzes Proposed and Final Rule changes to Medicare payment policies (e.g., Medicare Physician Fee Schedule, Outpatient Prospective Payment System, Ambulatory Surgery Center) and publicly available Medicare data (including payment, cost, and utilization data) to evaluate client strategies
  • Monitors national and local policies on coverage and payment for products and services and prepared issue memoranda for clients and advocacy groups