A pharmaceutical company with an FDA-approved non-opioid treatment for chronic pain faced a significant market access challenge when the Centers for Medicare & Medicaid Services (CMS) proposed a reimbursement policy that could restrict physician reimbursement for prescribing the therapy.
If implemented, the policy would create barriers to patient access, limit physician adoption of innovative treatment options, and potentially drive greater reliance on generic therapies and prescription opioids.
At a time when federal efforts, including the SUPPORT Act, were encouraging the adoption of non-opioid pain management approaches, the proposed rule threatened to undermine patient access to a clinically valuable treatment option.
The company needed an effective strategy to ensure that the perspectives of patients and healthcare providers were represented in the policy discussion.
PAS developed and executed a stakeholder engagement initiative designed to demonstrate the real-world impact the proposed reimbursement policy could have on patients living with chronic pain.
Working closely with patients, healthcare providers, advocacy organizations, and other key stakeholders, PAS amplified authentic patient experiences and clinical perspectives that highlighted the value of maintaining access to innovative non-opioid treatment options.
PAS identified individuals who had experienced meaningful improvements in pain management and helped elevate their stories in a way that informed policymakers and other decision-makers.
To broaden the reach and impact of the effort, PAS mobilized more than 50 advocacy organizations to support opposition to the proposed reimbursement policy.
Through coordinated engagement activities and written submissions, PAS helped create a unified voice focused on protecting patient access to treatment and preserving physician choice.
The stakeholder engagement campaign successfully influenced the final outcome of the CMS reimbursement policy.
Exposure to patient experiences, provider perspectives, and coordinated advocacy efforts contributed to modifications of the proposed rule that protected patient access to important chronic pain treatment options.
As a result, patients maintained access to innovative non-opioid therapies, healthcare providers retained the ability to prescribe appropriate treatment options, and the client preserved access to a favorable reimbursement environment for its therapy.
By combining patient storytelling with strategic stakeholder engagement, PAS helped ensure that the patient perspective played a meaningful role in the policy decision-making process.
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