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Market Access: Another Piece of the Patient Journey Puzzle

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In a perfect world, matching the right patient to the right therapy would be as simple as identifying an eligible individual, and writing and fulfilling a prescription. We do not live in a perfect world.

Instead, the process of getting patients access to the therapy they need is governed by a complex web of national and regional insurance policy data, reams of clinical evidence, and local availability of the treatment. Sitting at the center of all of this is the formulary, which is the master list of prescription drugs covered by a health insurance plan. In today’s increasingly specialized and often very expensive world of prescription drugs, if a drug is not on enough health plan formularies, it may as well not even exist.

Understanding Market Access

Any company working to reduce the burden of disease needs to consider not only the science behind developing innovative therapeutics and the nuances driving real-world provider and patient behaviors, but also the business of healthcare. It’s why the announcement of our acquisition of Breakaway Partners, the leading software company in the market access industry, is so important.

Breakaway Partners has developed real-time AI solutions to track national, state, metro area, and county-level formulary data, prescription policy criteria, payer coverage, and other insights to evaluate the market landscape for new and existing therapies. By bringing these data together in one place with easy-to-use software backed by outstanding customer success, Breakaway has made it possible for life sciences companies to quickly determine the overall accessibility of their therapies across every zip code in the U.S.

That itself is a leap forward from the legacy process of making market access decisions based on manual analyses of often incomplete and out-of-date aggregated formulary data. As Breakaway Partners joins Komodo, we are redefining what is possible. By pairing formulary data and prescription policy criteria with Komodo’s Healthcare Map™, we’re creating the first enterprise market access solution suite, based on a comprehensive, real-time view of real-world outcomes and cost.

And that changes everything.

Powering Patient-Driven Insights

The Komodo and Breakaway partnership will make it possible to quickly understand and prioritize patient access based on the existing policies and the specific needs of differing patient populations. As healthcare payers and providers continue to shift to value-based payment models, payers, providers, and life sciences companies need faster, more complete insights to bridge the gap between new breakthroughs, the potential impact on patient outcomes, and formulary decisions.

With our combined insights and single interface software, life sciences teams will be able to navigate the current formulary landscape with added intelligence from real-world patient outcomes for existing therapies, insights on patients in a particular region who would benefit most from a new therapy, and – most importantly – a deeper understanding of patients who are not currently receiving therapies they need.

We know that gaps in access mean gaps in care. By understanding and prioritizing patient access based not only on the current landscape of existing policy restrictions, but also on the real-world experience of individual patients, providers can better advocate for specific therapies, payers can make truly value-based formulary decisions, and life sciences companies can build access strategies based on existing unmet needs. For example, by visualizing the current formulary landscape in context with upcoming policy changes and real-world patient behaviors, life sciences teams will be able to not only project what impact an approval or rejection change will have on the total addressable market, but also to adjust their strategy to preempt such changes before it’s too late.

Redefining the Status Quo with Powerful Analytics

Together, this combination of our Healthcare Map and Breakaway’s market access solutions gives us the ability to improve patient access to the most effective therapies on a massive scale. This is bigger than just an efficiency play or a new-and-improved software solution; it’s going to transform the way the industry makes decisions.

Komodo-Bolt-210722 v2b(Left to right: Christian Pinsonault, Jeff Stewart, Arif Nathoo, Web Sun, PJ Santoro, and Andrew Laubscher)

 

We are thrilled to be advancing market access intelligence, and we look forward to continuing our expansion across the healthcare ecosystem, delivering a range of real-world data, analytics, and enterprise software solutions designed to close gaps in care, improve access, and reduce the burden of disease.

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