Pathways Programs Impact Assessment

Pathways
CLIENT: An industry leading biotechnology company, with a primary focus in oncology, sought to quantify the current and anticipated future impact of emerging pathways programs on their portfolio.
BUSINESS QUESTION: What is the impact of pathways programs, how is this forecasted to evolve over a 3-year outlook, and how can our client maximize opportunities to maintain appropriate access in light of this emerging influencer?
OUR APPROACH:
  • A landscape assessment of current oncology management programs was initially conducted to develop a working definition for ‘pathways’ programs, allowing prioritization of programs by business model
  • ISA’s Oncology & Specialty Therapeutics Team conducted in-depth discussions with their continuously-refreshed network of Pathways and Oncology Benefit Manager accounts, Payers engaging in pilot and full scale programs, participating community practice and hospital managers, and member oncologists of pathways development committees, to further assess:
    • Characteristics of each program, including tumor type coverage, detailed financial incentive structures, cost savings estimates, evaluation criteria for product positioning, and direct / indirect influence points of development processes
    • Current share of lives and practicing oncologists by pathways program, along with growth projections based on historical uptake rates
    • Current and anticipated product positioning across the clients’ portfolio of product indications, including high-level perspective regarding model restrictiveness
    • Developed a quantitative framework to estimate current and long-term utilization impact across the client portfolio, and further prioritized these programs by ability to influence
    • Developed a quantitative predictive model to identify payer accounts by geography with the greatest likelihood of pathways adoption (based on analysis of the association between historical adoption and hypothesized drivers of adoption, e.g. payer dominance in an MSA)
RESULT: ISA recommended specific strategies and tactics to mitigate barriers of appropriate access. The client also conducted internal planning initiatives based on signposts identified by this work to track milestones of anticipated model evolution.