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March 10th, 2009
Reimbursement Planning: Reverse Engineering Drug Development to Meet Changing Payer Requirements
Speakers for this event:
  • Eric Faulkner, MPH, Senior Director, Market Access and Reimbursement, RTI Health Solutions, and Executive Director, Genomics Biotech Institute, National Association of Managed Care Physicians  Learn More
  • Allan Jay Kogan, MD, Vice President and Regional Medical Director, CIGNA  Learn More
  • Jayson S. Slotnick, Associate, Hogan & Hartson LLP  Learn More
  • Reimbursement Planning: Reverse Engineering Drug Development to Meet Changing Payer Requirements

    Payer scrutiny, pricing and reimbursement hurdles for new drugs and biologics have increased significantly in the US and globally. This makes it critical to develop strategic plans for reimbursement.  In the current environment, product development efforts must start with reimbursement as a central focus. Clinical and economic evidence development and commercialization efforts must be carefully engineered and coordinated among internal functions and across the product’s life cycle to optimize market access and reimbursement potential.  “Cookie cutter’ approaches are yielding to customized strategies with sufficient flexibility to weather an evolving reimbursement environment driven by value demonstration and comparative effectiveness.


    How should manufacturers retool to navigate reimbursement planning in this brave new world? This seminar will assemble pricing and reimbursement, payer and industry experts in an open forum discussion focused on the following key questions:

    • What steps should you take to “reverse engineer” for value demonstration and successful reimbursement?
    • How do you distinguish “got to have” versus “nice to know” evidence requirements to develop a reimbursement-focused product development plan?
    • How do you balance lessons learned from existing products against future payer requirements to anticipate pitfalls and enhance value differentiation?
    • What can you do to avoid risks and seize opportunities precipitated by trends such as comparative effectiveness, personalized medicine and technology convergence?
    • What are some examples of existing technologies that effectively navigated payer hurdles based upon solid reimbursement planning? What lessons can be learned from these examples?

    Senior level executives involved in pricing and reimbursement for the pharmaceutical, biotech and medical device industries.

    Senior level executives responsible for managed care for large pharmaceutical companies in the U.S. 


    Eric Faulkner, MPH
    Senior Director, Market Access and Reimbursement, RTI Health Solutions, and
    Executive Director, Genomics Biotech Institute, National Association of Managed Care Physicians  

    Eric C. Faulkner, MPH, is Senior Director of US Market Access and Reimbursement at RTI-HS. He has approximately 12 years of experience focusing on health technology assessment, product reimbursement and commercialization, health care management, and health policy analysis. Prior to joining RTI-HS, Mr. Faulkner was a senior consultant at the Littell Group and The Lewin Group. In these positions, he managed a portfolio of consulting projects, including reimbursement strategy analysis, evaluation of the clinical and economic impact of the in vitro diagnostics industry, design of clinical trials to meet requirements of third-party health decision makers, life sciences stakeholder surveys, burden of illness studies, and analysis of key health policy initiatives. In previous positions, he provided intellectual property consulting services and managed a variety of genomic and molecular research initiatives for the NIH and Duke University. Additional responsibilities have included participation in a number of expert advisory groups addressing ethical, legal, policy, and commercial/operational issues relevant to the life sciences industry. Mr. Faulkner holds a bachelor’s in biology from Radford University and a master of public health in health policy and administration from the University of North Carolina at Chapel Hill.

    Mr. Faulkner has recently served as an expert advisor to the Personalized Medicine Subcommittee of the President’s Council of Advisors on Science and Technology and is serving as a lead editor for an upcoming book entitled Medical Device and Diagnostics Outcomes Research: Issues and Good Research Practices, sponsored by the US Medical Device and Diagnostics Council of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR).

    Mr. Faulkner has significant experience in evidence-based practice and policy. He has served as a project manager for the AHRQ Evidence-Based Practice Center program and US Preventive Services Task Force (USPSTF) initiatives, including process management, stakeholder communications, systematic literature assessment, meeting planning and thought leader recruitment, and development of a novel horizon scanning approach. Mr. Faulkner has managed multiple public and commercial health technology assessments of drugs, medical devices, and diagnostics, including cognitive and neurodegenerative disorders, stem cell transplantation, oncology, cardiovascular disease, diabetes and metabolic syndrome, hypertension, depression and psychological disorders, dermatological disease, sexually transmitted and infectious disease, and health care management issues. He has also led health policy assessments, including CMS’s Coverage with Evidence Development (CED) and Clinical Trial Policy, value-based purchasing, competitive bidding, cost-effectiveness, comparative effectiveness, pharmacogenomics, and health care transparency for life sciences manufacturers, industry and medical professional associations, and government agencies, including HHS, NIH, FDA, CDC, and ASPE.

    Mr. Faulkner also serves as Director of the Genomics Biotech Institute (GBI) of the National Association of Managed Care Physicians and Editor-in-Chief of the GBI section of the Journal of Managed Care Medicine. He has significant experience in evaluating novel molecular diagnostics, targeted therapeutics, and personalized medicine approaches and how these advances influence medicine and health policy and enable new paradigms of health care delivery. Mr. Faulkner also has a strong commitment to helping payers, providers, employers, patients, policy makers, and other health stakeholders work collaboratively to address opportunities and challenges associated with adoption and diffusion of emerging genomic, biotechnological, and other technological innovations.


    Allan Jay Kogan, MD
    Vice President and Regional Medical Director, CIGNA  

    Certified Physician Executive, American College of Physician Executives, Orlando, FL

    Family Practice Residency, Thomas Jefferson University Hospital, Philadelphia, PA

    MD, Baylor College of Medicine, Houston, TX

    MS, Strategic Studies, Army War College, Carlisle Barracks, PA

    BA, Boston University, Boston, MA


    Dr. Kogan has over 30 years of healthcare experience, including 12 years as regional

    medical director, including for Aetna, NYLCare, and Blue Cross/Blue Shield of Texas,

    holding titles of Vice President and Senior Medical Director. He is currently Vice

    President and Regional Medical Director for a leading commercial contracting health

    plan. Dr. Kogan also has a distinguished record of military medical service, including

    Operation Enduring Freedom, Operation Noble Eagle/Iraqi Freedom, Operation Joint

    Endeavor, and Operation Desert Shield/Dessert Storm. He has held faculty appointments

    in the departments of community and family medicine and internal medicine at the

    University of Pennsylvania, Thomas Jefferson University and the University of Arizona,

    is Board Certified in Family Practice and is a Certified Physician Executive (CPE).

    Jayson S. Slotnick
    Associate, Hogan & Hartson LLP  

    Jayson Slotnik’s practice focuses on health care regulatory issues, with an emphasis on coverage, coding and reimbursement for devices, diagnostic tests, drugs, and biologicals under all parts of Medicare.

    Prior to joining Hogan & Hartson, Jayson was Director of Medicare Reimbursement and Economic Policy at the Biotechnology Industry Organization in Washington, D.C. where he represented the industry in front of the Centers for Medicare and Medicaid Services, U.S. Congress, and other regulatory agencies. Jayson counseled companies of all sizes on an appropriate reimbursement strategy.

    Before that, he spent several years as a health care regulatory associate where he focused on legal, regulatory, and federal legislative issues arising under Medicare, Medicaid, and the Federal Food, Drug and Cosmetic Act, and functioned as regulatory counsel to managed care organization operating in nine states.

    While attending law school, Jayson served as a judicial clerk for the Honorable Charles Day on the U.S. District Court for the District of Maryland. He also interned at the National Cancer Institute, National Institutes of Health where he drafted memoranda and reviewed licensing agreements on behalf of branch scientists.


    RTI Health Solutions (RTI-HS) provides leading consulting and research expertise to define, measure and communicate value for pharmaceutical, biotechnology, and medical device products.

    Offering broad professional and industry experience, RTI-HS staff includes experts in, pricing and reimbursement, health economics, patient-reported outcomes. We work with clients to help them design and implement pricing strategies that capture the value of their products and gain formulary access and reimbursement.

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