Our common goal is to reduce enterprise risk and expedite execution.

Leveraging chief executive leadership; from the ranks of the most distinguished commercial and government healthcare market makers to immediately gain knowledge from real world experience.

The Upstream team has competitively swum through the market channels to ensure safe passage when navigating the policy, regulatory, access and reimbursement challenges ahead in the ever-changing healthcare environment tomorrow. In the throws of a continuously evolving and complex healthcare delivery ecosystem our teams benefit of the “been there done that experience” is your advantage.

Upstream team members have a deep professional network of stakeholder contacts across channel disciplines. We have direct, face-to-face access to the key opinion leaders. Lastly, our “thinking out of the box” and ability to see clearly into the future keeps your strategic plan many steps ahead of market movements. Our collective goal is to leverage real world experience and lessons learned to establish the competitive advantage, accelerate the implementation and launch process while minimizing the known and trending business risks.

WE FORESEE MARKET TRENDS TO ENSURE TIMED SUCCESS

Work Streams

Pre-Post Product Launch Support

  • Health Policy
  • Regulatory Environment
  • Legislative Policy
  • Capitol Hill
  • CMS
  • MedPAC
  • FDA
  • NIH

Market Intelligence

  • Market and Segment Perception/Validation
  • Customer Segmentation
  • Expected Product Placement and Market Sizing
  • Assessing Channel Risks
  • Competitive Composition and Positioning
  • Shaping Coverage and Utilization Metrics
  • Formulary Tier and Positioning Models
  • Expected Medical and Clinical Coverage Policy
  • Advocacy Development

Strategic BD

  • Value Based Market Proposition
  • Marketing Plan
  • Key Opinion Leader Managed Markets Advisory Panel
  • Lifecycle Planning
  • Product Support Programs and Services
  • Contracting Segmentation Models

Pre-Post Launch

  • Clinical Study Transition to Commercialization
  • Clinical Study Validation
  • Expected Managed Market Forces Assessment
  • Managed Markets Introductions and Access Support
  • Sales Recruiting, Training and Support
  • Market Launch and Mobilization
  • Channel Performance Review to Optimization

Reimbursement

  • Segment and Channel Pricing Stratification
  • Formulating Channel Pricing and Performance Fees
  • Gaining and Improving Coverage
  • Evidenced Based Consensus Guidelines
  • Pharmacy and Therapeutics Committee Support
  • Payment Coding
  • Rebate and Contracting
  • Patient Financial Assistance
  • Prior Authorization Support
  • Grievance and Appeals Process Plan
  • Reimbursement Optimization Models

Pharmaceutical Supply Chain Channels

  • Wholesale
  • TPL Third Party Logistics
  • HUB Product Support Services
  • Specialty Pharmacy Network Formation
  • Network Credentialing, Build and Contracting
  • Limited Distribution Networks
  • High Performance Network Management
  • Vendor Contracting RFI-RFP

Real World Analytics and Analysis

  • Data Set Registry Requirements
  • Outcomes and Clinical Value Data
  • Episode of Care Population Health
  • Analytics Decision Support
  • Ongoing Product Performance Tracking
  • Vendor Selection RFI, RFP

Therapy Management

  • Patient Centric Clinical Support Programs
  • Patient Education Starter Programs
  • Compliance and Persistence Programs
  • Medication Treatment Management Programs
  • Performance Based Supporting Programs
  • Disease Management Programs

Payer Market Channels

  • Commercial Insurers
  • Self Insured TPA
  • Government; Medicare, Medicaid, VA, 340B
  • International Markets
  • Integrated Health Delivery Systems
  • Long Term Care
  • Specialty Providers
  • Centers of Excellence

Pharmacy Management Channels

  • Retail Independent Pharmacy
  • Mail Order Pharmacy Chain
  • Chain Pharmacy
  • Specialty Pharmacy
  • Vendor Contracting RFI-RFP
  • Integrated Health Delivery Systems
  • Home Infusion

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