BluePeak’s value to pharma stems from our extensive knowledge of the health plan, PBM and employer client marketplaces since we deal with them daily. We have in-depth experience with CMS policy and operational issues, and experience with many of the current PDPs and MAPDs. We understand how they think and what decisions will likely be made.  Coupled with our knowledge of the pharmaceutical industry, we can support you in your Medicare and managed care market and reimbursement strategies.

Consisting of former CMS regulators, health plan and PBM operations and compliance experts. BluePeak prides itself in cutting edge knowledge and experience in all disciplines. Our consultants have worked in pharma, PBMs, and health plan/employers for over 30 years and maintain continuous involvement with pharmacy associations and industry groups.

Our services to pharmaceutical companies across all markets include:

Strategy

  • Strategic Product Planning/Reimbursement Strategies:  BluePeak works closely with pharmaceutical companies on new products to assist with product launches, market messaging and government and commercial reimbursement strategies.
  • Formulary Management Strategies: What will the plans and PBMs do to manage the new product?  Step therapy, prior authorization, and lock-out?  How will Medicare handle it?  BluePeak can provide insight into these issues with staff who have been working on Pharmacy and Therapeutics Committees their whole careers and who currently work with all the major health plans and PBMs.
  • Pull-through Strategies: What are plans able to do to drive market share in a particular drug class in particular markets?  BluePeak consultants can help pharma with most likely strategies that plans and PBMs will employ.
  • Client Strategies and Issues Support: BluePeak can support pharma companies with factual information on what government entities are telling health plans and PBMs regarding formulary management. Learn what the HPMS and regulatory guidance from CMS really means.
  • Contracting Strategies and Support:  Are there innovative contracting strategies that will produce desired market share movement in a particular therapeutic class? BluePeak consultants can assist with these questions.

Operations

  • Advisory Board Development, Moderation and Participation: BluePeak can assist with content development, key opinion leader recommendations for advisors, participate on advisory boards for Medicare and managed care related issues and moderate the day if needed.  Consultants have been working in managed care for over 30 years, know the players and are experts at soliciting critical information that pharma needs to support its marketing efforts.
  • Interim Staffing: BluePeak can provide interim policy staffing for pharmaceutical companies who may be small and just getting started, or if you have unexpected departures or extended leave in your policy department.

Other Medicare Services

  • Policy Analysis Affecting Formulary and Other Business Decisions: BluePeak analyzes the legislative environment on a daily basis and is aware of the critical legislative issues that are happening in Medicare and other managed care related areas.  We can track and trend these issues in order to inform your teams on potential business issues affecting your products.
  • CMS Advocacy and Planning: Pharma companies often want to take issues to CMS that are related to their products, but is it the right time?  The right issue?  Are you seeing the right people who have impact on your decisions?  Should you use your political capital on a particular issue?  BluePeak can answer these questions and offer advice in this critical area.
  • HPMS Memos Service: With CMS releasing daily guidance, it is difficult to keep up. BluePeak provides summaries of all memos, with analysis, and can sort for issues that are specific to your company, saving you time and money sifting through all the data. This service is complimentary for our retainer clients.