The future of a small medical device start-up rested on a single product in clinical trials. As executives prepared for market launch, they wanted to define the product’s most promising reimbursement strategy. Similar technology was already being sold in the U.S. by a large medical device manufacturer. This gave us a basis for comparing and contrasting potential options.
Our consultants performed an in-depth environmental analysis to uncover coding, coverage and payment issues associated with the competitor’s product and comparable technologies.
Research revealed coding controversies surrounding the competitive offering. These snags led multiple payers to refuse coverage. Moreover, the competitor was denied approval of a new CPT code to remedy coding concerns.
The analysis helped us pave the way to a more effective reimbursement strategy for our client – avoiding errors that hindered its primary competitor. This freed the single-product company to reallocate resources to other business priorities – including repositioning for market entry and completion of a code application.
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