MORRISVILLE, NC—Policy Reporter today announced the launch of its Coverage Viewer—Pharmacy Edition, becoming the first and only provider in the marketplace to offer detailed policy coverage criteria layered with both pharmacy and medical covered lives data. As a result, life science companies can now receive the most accurate, real-time data to inform brand access and health plan contracting decisions.
Pharmaceutical and medical policies are complex, unstructured documents that can be challenging to capture and navigate. Policy Reporter, acquired by TrialCard in 2019, expertly automates the necessary, but often frustrating, act of staying abreast of policy and formulary information across the payer landscape. Historically, no single vendor has provided both pharmacy benefit and medical benefit coverage documents together with the covered lives data necessary to understand the impact of these documents, including coverage policies, prior authorization forms, and more.
Policy Reporter’s Coverage Viewer—Pharmacy Edition assigns pharmacy benefit covered lives to a PBM, its clients, and its different lines of business. This includes commercial, Medicare Advantage, and managed Medicaid, among others. This level of covered lives detail is essential to understanding how patient access is managed for different segments of covered lives. Health plans increasingly differentiate their documents by line of business and carve out the management of specific drugs and even entire drug classes from the PBM. The health plan retains responsibility for coverage management or assigns coverage management by a separate benefit manager. Covered lives detail included in Coverage Viewer—Pharmacy Edition allows a user to navigate the landscape of health plan documents and understand the management of coverage for different segments of covered lives.
“Merging policy coverage criteria with pharmacy and medical covered lives data is a game-changer for our clients,” said Scott Dulitz, TrialCard’s Chief Strategy Officer. “The ability to offer this in real-time with our patented technology means that our customers have the most accurate information that will drive sound market access and health plan contracting decisions. This enhanced payer intelligence can be used to make important determinations that affect how our clients’ products are covered.”
“Policy Reporter has spent the past decade perfecting our ability to track data in real-time—and we do that very well,” added Drew Gutschmidt, President of Policy Reporter. “We are now pleased to be able to deliver this information in a way that truly empowers our clients. It’s transformational to unlock the criteria within these coverage documents and combine that data with formulary, payer, plan, and PBM market share to increase patient access.”
About Policy Reporter
Policy Reporter provides innovative healthcare software solutions to track payer policies in near real-time and enhances market access for the therapies patients need most. The company’s patented software-driven solutions include a suite of billing and reimbursement tools for providers and laboratories, market intelligence tools for payers and a suite of market access solutions for life science companies. Its clients include some of the world’s largest pharmaceutical and healthcare companies. For more information or a free demo, please visit https://www.policyreporter.com.
TrialCard Incorporated provides patient affordability, medication access and adherence, patient support, and clinical trial services on behalf of biopharmaceutical manufacturers. Founded in 2000, TrialCard has connected over 35 million patients with more than $18 billion in branded drug savings to date. The company is headquartered in Morrisville, North Carolina. For more information about TrialCard, please visit www.trialcard.com.