Pricing & Reimbursement

Zeumed designs, stress-tests, and supports the implementation of pricing and reimbursement frameworks for medicines and health technologies — combining policy expertise with economic modelling grounded in how these decisions play out in practice, and informed by deep familiarity with both sides of the negotiation table.

The frameworks that govern how medicines and health technologies are priced, reimbursed, and negotiated have long-term consequences for access, affordability, market behaviour, and supply stability. Reimbursement routes differ across markets and evidence requirements vary by payer.

FOR MANUFACTURERS

Building the case for market access and reimbursement

Pricing and reimbursement strategy should be embedded in product development from the start, ensuring that clinical trials include outcomes that matter to payers. The evidence payers require, the value proposition they will accept, and the price they will fund are questions that shape trial design.

Zeumed works with manufacturers to build the economic case for reimbursement, model price scenarios, and prepare for negotiations with a full understanding of how payers assess and decide.

This work includes:

HTA strategy and evidence requirement planning
Economic modelling — cost-effectiveness, budget impact, price simulation
Value proposition design from clinical and payer perspectives
Negotiation preparation and counter-argument analysis
International reference pricing and launch sequencing

FOR PAYORS AND GOVERNMENT

Frameworks for assessing and funding digital technologies

Pricing and reimbursement frameworks must function through innovation cycles, patent expiry, negotiation rounds, and shifts in global pricing policy. Designing frameworks that are technically sound, fiscally controlled, and durable under pressure requires both analytical depth and an understanding of how manufacturers will respond.

Zeumed advises on framework design and reform, models the fiscal and market implications of policy choices, and supports negotiations with a clear view of the manufacturer position.

This work includes:

Design and reform of pricing and reimbursement frameworks
Innovative contracting, including outcomes-linked, staged payment models
Negotiation strategy and fiscal impact assessment
International reference pricing and cross-market spillover analysis
Supply chain security and market functioning assessment

WHAT WE DO

Pricing & Reimbursement Services

Framework design & reform

Developing and reviewing pricing and reimbursement rules that balance access and affordability while maintaining predictable expenditure and functional markets — across originators, generics, and biosimilars.

Innovative Contracting

Designing and assessing managed entry agreements for medicines and health technologies where standard reimbursement is not fit for purpose — including outcomes-based agreements, clawback and payback mechanisms, and arrangements structured to evolve as real-world evidence accumulates over the product lifecycle.

Negotiation Strategy

Supporting payer and manufacturer negotiations — including preparation of economic and policy positions, anticipation of counter-arguments, and assessment of fiscal and market implications of different negotiation outcomes.

International Pricing Dynamics

Analysing how domestic pricing and reimbursement decisions interact with international reference pricing, MFN-type policies, and cross-market spillovers, including implications for launch sequencing, affordability, and long-term access.

Generics & Biosimilars

Assessing how pricing, reimbursement, and contracting choices affect incentives for market entry, generic competition, and supply resilience, particularly in settings exposed to shortages or concentration risk.

OUR WORK

Selected Engagements

PAYER · REIMBURSEMENT FRAMEWORK · NATIONAL

Pricing and reimbursement framework design for a national payer

Zeumed designed a comprehensive pricing and reimbursement framework for a national payer — establishing assessment criteria, reimbursement rules, and funding mechanisms across originator medicines, generics, and biosimilars. The framework was designed to balance access and affordability under real fiscal constraints, with modelling of expenditure trajectories and market behaviour under different policy scenarios.

MANAGED ENTRY· INNOVATIVE MEDICINES· PAYER & MANUFACTURER

Managed entry agreement design for high-cost innovative treatments

Zeumed advised on the design of managed entry agreements for a category of high-cost innovative treatments where standard reimbursement approaches were not fit for purpose. The work included outcomes-linked payment components, expenditure cap design, and modelling of fiscal risk under different uptake and outcomes scenarios — producing an agreement structure that addressed payer affordability concerns while supporting manufacturer access to the market.

Get in Touch

We welcome enquiries from manufacturers and payers working on pricing strategy, reimbursement framework design, and negotiation preparation.