Building a budget impact model for AMCP submission in the US

Our client was launching a new treatment in the US. They were looking for a health economics consultancy with knowledge of the US market to develop a budget impact model that would resonate with US payers and generate data suitable for Academy of Managed Care Pharmacy (AMCP) formulary submission.

Our client was looking to develop the budget impact model in a way that would enable future adaptation for other countries and reimbursement routes, with a view to later accommodate the requirements of other global markets.

We began with an introductory workshop to understand the client’s goals, explore the treatment landscape, and share existing materials.

Using the learnings from this workshop and drawing on our previous expertise working with US payers and on AMCP submissions, we then developed a conceptual model framework for the new treatment. This included the model flow, data gaps, and potential data sources. This conceptual model was presented to the client in Microsoft PowerPoint for their approval.

Once the conceptual model was validated by the client, our health economists developed the full budget impact model in Microsoft Excel.

Our health economists conceptualised and developed a budget impact model that would generate data that showcased the treatment’s budgetary impact for US payers over a 3–5 year timeframe.

In addition to the Microsoft Excel model, we also provided the client with a user guide in Microsoft PowerPoint, a highlighted reference pack and a report in Microsoft Word for inclusion in their AMCP dossier.

The client has now asked us to adapt the model for key European markets.

Following the scoping work, the client asked if we could include additional functionality to target an expanded audience with alternative cost assumptions and different clinical efficacy outcomes. We were able to flexibly accommodate these additional requirements and identify additional data sources for these.

Our expert health economic modellers included bespoke and novel functionality to facilitate easy adaptation of the model for use in other markets. As a trusted partner, our client asked us to support affiliates with these adaptations.