3 History ADVI, a merger of HillCo HEALTH and AccelusHealth Partners was founded by Marc Samuels and Lawrence Leisure in 2013. Our team members translate the value of client products and services into the language and currency of payers, both public and private. In doing so we create value for new or existing clients by accelerating time to revenue and profitability with a higher degree of market certainty.
4 Where we are Menlo Park Austin Brazil London EU Australia Washington DC Primary Offices Global Associate Network
5 Our Mission Provide a balanced viewpoint on reimbursement, accelerating time to revenue, and idea generation Be unique among advisory firms Be relentless to ensure we do the right thing for the right reasons for our clients with a view on the world as it will be, not just as it is today
6 Therapeutic Area Knowledge Tech Healthcare Delivery Systems EMR Digital and Interactive Health Media Diagnostics Image Processing Specialty Pharmacy Distribution DME Distribution Biotech & Drugs Oncology Oncology Supportive Cardiovascular Diabetes Respiratory Osteoporosis Alzheimer’s CNS Radiopharmaceutical s ESRD/CKD Multiple Sclerosis Dermatology General Surgery Transplant medicine Sensory organs Sports Medicine Urology Women’s Health Devices Brain cancer mapping and treatment Breast cancer monitoring Bio stimulation Cardiovascular technologies Bone Growth repair Urinary Incontinence Anal Bulking Ophthalmologic Spinal devices Transplant devices Sleep Apnea devices Deep Brain Stimulation Orthopedic Implant Wound Care Radiopharmaceuticals Diagnostics Biomarkers Pan cancer Multianalyte and NEXTGEN sequencing tests Companion diagnostics In Vivo diagnostics Molecular diagnostics Point of Care tests Image Mapping technology
7 Our Strengths Industry leading venture capital, private equity and investment banking cross firm practice Pharmacist and physician panels in oncology, radiation oncology and diagnostics Global Focus: International team with payer, industry and government experience Proven Results in pricing, reimbursement and market access strategies across US and Global markets Rare knowledge of the people, politics and processes inherent in CMS, FDA and HHS as well as the cancer community Access to cutting edge data analytics and research Modelling capabilities to support health technology assessment (HTA)/gap analysis and business case development Unique access to national, regional and local payers across the USA, in both public and private settings of care
8 ADVI IS UNIQUE: Government, scientific, industry, payer, and professional consultancy experience and expertise in one company
10 ADVI Strategic and Tactical Expertise Coding & Payment Strategy Value Foundation: Clinical value and health econ value established Reimbursement/Payer Strategy: Targeted payers identified, and approach developed Keeping Pressure: Influencers identified and managed, momentum sustained Payor Strateg y Data Outcome Scientific Economi c Obstacles in Obtaining Reimbursement Inconsistent decision-making criteria Systems not designed to recognize medical value Different systems in each country Lengthy process Multiple agencies and parties 1223 123 ADVI CAPABILITIES REACH ACROSS THE SPECTRUM
11 ? ? ? Key Strategic Questions Early Engagement Reimbursement and Payer Action Plan Focus Resources, Align Interests 1.Can you maximize the use of your resources by trying to capture payer related evidence during clinical trials 2.Have you sought payer input to validate your clinical evidence plan? 3.Are you engaging local KOLs that will support reimbursement activities? 1.What is your reimbursement strategy? And do we need payer specific strategies? 2.What is the optimal organization set up and process to deliver success? 1. Who are the stakeholders in pushing / guiding Payers on decisions? 2. How can you align and drive towards our Stakeholders’ defined success?
12 Possible Strategy Develop strategies of how the organization can create and maintain favorable access, reimbursement and across payer types Investigate current opportunities and challenges Understand coding, coverage and reimbursement Identify challenges, barriers and opportunities Implement tactics to create such an environment
13 Possible Strategic Implementation Develop landscape assessments mindful of evolving legislative and regulatory policies and national and local coverage trends; facilitate advisory boards, focus groups, and interviews with payer decision makers to assess issues and formulate strategies Analyze coding scenarios and develop strategic product positioning within the American Medical Association (AMA) CPT and RUC, CMS, and key medical specialty organizations; and create strategic solutions that complement marketing initiatives Advance strategic policy plans with appropriate agencies (CMS, AHRQ, state agencies, and targeted private payers); cultivate patient and professional advocacy support to address policy changes ADVI KEY CAPABILITIES DRIVE SUCCESS
14 WASHINGTON DC AUSTIN SAN FRANCISCO ADVI.COM 202 509 0760 610 10 TH STREET N.W. SUITE 400 WASHINGTON, DC 20001