Para agilizar el proceso de Evaluación de Tecnologías Sanitarias (ETS) en los estados miembros de la UE, se implementarán cambios significativos en enero de 2025. En lugar de que los fabricantes de nuevas tecnologías sanitarias deban presentar datos clínicos en cada estado miembro, según el Reglamento (UE) 2021/2282, la evaluación se llevará a cabo de manera conjunta. Los fabricantes solo necesitarán presentar las evaluaciones clínicas una vez, aunque los estados miembros aún podrán realizar evaluaciones complementarias.

Es importante destacar los 9 dominios de evaluación, de los cuales 4 son clínicos y 5 no clínicos. Las 4 evaluaciones clínicas incluyen:

• Evaluación de la enfermedad y el panorama actual del tratamiento

• Examen de la nueva tecnología sanitaria

• Seguridad

• Eficacia

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Los 5 dominios no clínicos incluyen:

• Costo y evaluación económica

• Ética

• Impactos organizacionales

• Impactos sociales

• Aspectos legales

España publicó su Proyecto de Real Decreto el 12 de agosto, que está abierto a comentarios hasta el 20 de septiembre, donde se detalla cómo se alinearán con la Directiva. Este esfuerzo involucra a la Oficina de Evaluación de la Eficiencia de los Medicamentos, que opera como una unidad funcional bajo la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS).

Además de las evaluaciones clínicas conjuntas en Europa, también habrá consultas científicas conjuntas. El objetivo de esta Directiva es reducir el trabajo administrativo duplicado y eliminar barreras a la innovación, al tiempo que se mejora el resultado para los pacientes.

A medida que estos cambios redefinen el panorama, es crucial que las empresas farmacéuticas y de tecnología médica se adapten rápidamente. Lyfegen puede ayudarle a mantenerse a la vanguardia con nuestras soluciones innovadoras:

• Navegue por los nuevos requisitos regulatorios: Acceda a nuestra extensa Biblioteca de Acuerdos, que incluye más de 5,000 acuerdos de precios de medicamentos públicos y 20 modelos de precios, para asegurar el cumplimiento con los últimos estándares de ETS.
  

• Optimice la toma de decisiones: Utilice nuestro Simulador de Contratación de Medicamentos para crear casos de negocio basados en datos y realizar simulaciones en tiempo real que se alineen con las nuevas directrices de ETS en España.
  

• Simplifique y automatice la contratación: Nuestras soluciones de análisis de reembolsos automatizan los cálculos de reembolsos y devoluciones, asegurando precisión, transparencia y una reducción significativa de la carga administrativa.

Reserve una demostración con nosotros hoy para explorar cómo las herramientas y la experiencia de Lyfegen pueden apoyar su negocio bajo el nuevo marco de ETS en España.

Reserve su demostración aquí: https://www.lyfegen.com/demo  

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Un cambio importante en Medicare Parte D entrará en vigor el próximo año, como resultado de la Ley de Reducción de la Inflación. Lo más notable es que el tope de gastos de bolsillo se reducirá de $3,300 a $2,000.

• Los beneficiarios podrán inscribirse en el Plan de Pago de Recetas de Medicare, que implica pagos mensuales de menos de $200 en lugar de un pago único en la farmacia.
  

• La proporción de los costos totales de los medicamentos cambiará. Este año, el 20% de los costos de cobertura catastrófica están cubiertos por el plan Parte D y el 80% por Medicare. El próximo año, el 60% estará cubierto por la Parte D, solo el 20% por Medicare, y el 20% por el fabricante.
  

• Se eliminará el requisito de un copago del 5%, lo que ahorrará a los pacientes miles de dólares en costos de bolsillo, especialmente para aquellos que toman medicamentos más costosos.
  

Esto nos lleva a otro desarrollo importante.

Actualización del Programa de Negociación de Precios de Medicamentos de Medicare

El CMS anunció su selección de 10 medicamentos cuyo precio fue negociado hace unos días, el 15 de agosto. Los medicamentos seleccionados se identificaron como “medicamentos de fuente única”, lo que significa que no tienen equivalente genérico o biosimilar, y es poco probable que lo tengan en el futuro cercano. Se estima que los nuevos precios ahorrarán $6 mil millones en costos netos de medicamentos recetados, lo que representa una reducción del 22% en el gasto. Los nuevos precios entrarán en vigor el 1 de enero de 2026.

A medida que la industria farmacéutica atraviesa estos cambios, es crucial contar con las herramientas adecuadas. Aquí es donde Lyfegen entra en juego con sus soluciones innovadoras como el Simulador de Contratación de Medicamentos, una herramienta diseñada para ayudar a los equipos de Acceso al Mercado y Precios a mantenerse a la vanguardia en este panorama:

💡 Modelado eficiente de escenarios de precios: Cree y pruebe una amplia gama de contratos de reembolso de medicamentos, lo que le permite evaluar rápidamente el impacto en los ingresos brutos y los costos netos.

🤝 Colaborativo y diseñado para su propósito: Deje atrás las herramientas basadas en Excel con nuestra plataforma dedicada, diseñada para los equipos de Acceso al Mercado y Precios, reutilizable en diferentes mercados y activos.

⚡ Acuerdos más rápidos y mejores: Simplifique la creación de acuerdos de reembolso en un entorno colaborativo, ayudándole a responder de manera más efectiva a las nuevas presiones de precios.

No pierda la oportunidad de mantenerse a la vanguardia en este nuevo entorno regulatorio. Reserve una demostración con nosotros hoy: https://www.lyfegen.com/demo

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En Brasil, encontramos que los principales fabricantes que proponen contratos basados en el valor fueron Novartis, Pfizer, J&J Innovative Medicine y Roche. Entre los pagadores, identificamos 21 aseguradoras privadas entre 2021 y 2024. También agregamos a ANVISA (Agencia Nacional de Vigilancia Sanitaria de Brasil) y la Comisión Nacional de Incorporación de Tecnologías en el Sistema Único de Salud (CONITEC), el organismo de evaluación de tecnologías sanitarias (ETS) de Brasil.

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Áreas Terapéuticas

Las áreas terapéuticas que identificamos en los acuerdos públicos de Brasil incluyen:

• Enfermedades infecciosas

• Oncología

• Enfermedades metabólicas

• Cardiovascular

• Hematología

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Modelos de Precios

Nuevos modelos de precios de Brasil incluyen:

• Cobertura restringida

• Descuento fijo

• Cobertura con desarrollo de evidencia

• Garantía de resultados

• Límite de presupuesto

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Acuerdos Destacados

Estos acuerdos se destacan porque abordan enfermedades raras y de alto costo, y demuestran enfoques únicos para el acceso a medicamentos y reembolsos, incluyendo cobertura con desarrollo de evidencia, garantías de resultados y pagos a plazos.

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Fibrosis Quística:

1. Orkambi (2024): CED, Cobertura restringida, Pagos a plazos

2. Trikafta (2023): CED, Garantía de resultados, Cobertura restringida

3. Kalydeco (2020): CED, Cobertura restringida

Atrofia Muscular Espinal Infantil:

1. Zolgensma (2022): Garantía de resultados, CED, Pagos a plazos
   

Cáncer de Ovario:

1. Lynparza (2022): Cobertura restringida, CED (con aseguradoras privadas)

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Principales Fabricantes:

• Novartis

• Varios fabricantes (para genéricos)

• Pfizer

• J&J Innovative Medicine

• Roche

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Entendiendo el Proceso de ETS para la Aprobación de Medicamentos en Brasil

En Brasil, el proceso de Evaluación de Tecnologías Sanitarias (ETS) es gestionado por ANVISA y la Comisión Nacional de Incorporación de Tecnologías en el Sistema Único de Salud (CONITEC). El proceso incluye varios pasos:

1. Aplicación: Las compañías solicitan que sus medicamentos sean evaluados.

2. Evaluación: ANVISA y CONITEC evalúan los medicamentos.

3. Negociación y fijación de precios: Se negocian precios y términos.

4. Inclusión: Los medicamentos aprobados se incorporan al sistema con precios establecidos.

5. Reembolso: Los medicamentos listados son reembolsados bajo el sistema de salud pública.

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A medida que Brasil se convierte en un mercado clave para las empresas farmacéuticas, nuestra biblioteca ofrece información esencial para ayudarle a ingresar a este mercado de manera eficiente y antes que la competencia.

Para obtener más información sobre los acuerdos de acceso a medicamentos en Brasil o acceder a nuestra biblioteca, reserve una demostración con nosotros hoy: https://www.lyfegen.com/demo

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En este blog, seleccionamos acuerdos específicos en Canadá, Dinamarca y Brasil. Cada uno de estos acuerdos varía, y los elegimos para que pueda ver cómo los fabricantes abordan el acceso al mercado para diferentes medicamentos y regiones. Los contratos basados en el valor en estos mercados aceleran el acceso de los pacientes mientras comparten el riesgo financiero entre la industria farmacéutica y los pagadores, una situación en la que todos ganan.

Trikafta (Elexacaftor-Tezacaftor-Ivacaftor, Vertex Pharmaceuticals)

• Indicación: Fibrosis quística

• País: Canadá

• Tipo de acuerdo: Cobertura con desarrollo de evidencia (CED), cobertura restringida, garantía basada en resultados.

• Fecha: Julio 2022

La Agencia Canadiense de Medicamentos y Tecnologías en Salud requiere una reducción del 94% en el precio de Trikafta para que el tratamiento sea rentable. Los niños con fibrosis quística de entre 2 y 5 años son evaluados después de 1 año, para demostrar que se benefician del tratamiento. Los pacientes deben cumplir con una serie de criterios para ser elegibles para el tratamiento, lo que convierte al acuerdo en una combinación de cobertura con desarrollo de evidencia, cobertura restringida y basada en resultados.

Trikafta ya había sido aprobado para su uso en niños mayores de 6 años, pero realizar un ensayo clínico en niños de entre dos y cinco años se consideró “éticamente desafiante”. Sin embargo, un ensayo no controlado en este grupo de edad encontró que el tratamiento fue bien tolerado y redujo los biomarcadores de la condición. Para abordar las necesidades no satisfechas, reconociendo la falta de datos en esta población de pacientes, se negoció un contrato de CED con una reducción drástica en el precio.

Orkambi (lumacaftor/ivacaftor, Vertex Pharmaceuticals)

• Indicación: Fibrosis quística

• País: Brasil

• Tipo de acuerdo: Cobertura restringida, CED

• Fecha: Abril 2024

El Ministerio de Salud de Brasil llegó a un acuerdo con Vertex para permitir el acceso restringido a este tratamiento, mientras monitorea regularmente a los pacientes a los 30 días y a los 3 meses después de iniciar el tratamiento. El acuerdo incluye reembolsos si el tratamiento no logra los resultados clínicos deseados, alineando los precios con la efectividad.

Kalydeco (ivacaftor, Vertex Pharmaceuticals)

• Indicación: Fibrosis quística

• País: Dinamarca

• Tipo de acuerdo: Acuerdo de precio-volumen; precios de cartera

• Fecha: Octubre 2018

El organismo de adquisición danés, Amgros, y Vertex Pharmaceuticals llegaron a un acuerdo que proporciona acceso a una cartera de medicamentos para la fibrosis quística, incluyendo Orkambi (lumacaftor/ivacaftor) y futuras terapias, en 2019. A pesar de que esto ocurrió hace cinco años, es un excelente ejemplo de precios basados en cartera, donde los pagadores acuerdan pagar una tarifa fija por un grupo de medicamentos relacionados. Cuantos más pacientes los utilicen, menor será el precio por paciente.

Lynparza (Olaparib, AstraZeneca)

• Indicación: Cáncer de ovario

• País: Brasil

• Tipo de acuerdo: Cobertura restringida, garantía basada en resultados

• Fecha: Mayo 2022

Este acuerdo se realizó entre AstraZeneca y aseguradoras privadas en todo Brasil. El tratamiento se pone a disposición sin costos adicionales para el paciente y combina características de cobertura restringida con garantías de resultados. La cobertura continua depende de lograr una respuesta parcial o completa.

Zolgensma (onasemnogene abeparvovec, Novartis)

• Indicación: Atrofia muscular espinal (AME)

• País: Brasil

• Tipo de acuerdo: Garantía de resultados, CED, pagos a plazos

• Fecha: Diciembre, 2022

La terapia génica de Novartis, Zolgensma, se reembolsa en función de la necesidad de evidencia adicional, conocida como cobertura con desarrollo de evidencia. Esto implica usar la cobertura como un medio para obtener evidencia del mundo real, para compensar la falta de datos robustos de pacientes provenientes del ensayo clave. El acuerdo también divide el riesgo entre los pagadores y los fabricantes, al vincular el reembolso con los resultados obtenidos. Debido al gran potencial de la terapia para mejorar la calidad de vida de los niños con AME, el acuerdo permite que los pacientes elegibles comiencen a recibir el tratamiento rápidamente.

¿Quiere ver la biblioteca por sí mismo? Reserve una demostración hoy aquí: https://www.lyfegen.com/demo

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To streamline the HTA process across EU member states, sweeping changes will go into effect in January of 2025. Instead of manufacturers of new health technologies needing to submit clinical data to each member state, under Regulation (EU) 2021/2282, the assessment will be conducted jointly. Manufacturers will only need to submit clinical assessments once, but member states can still conduct complementary assessments.

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Important to note are the 9 assessment domains, of which 4 are clinical and 5 are non-clinical. The 4 clinical assessments include:  
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• Evaluation of the disease and the current treatment landscape

• Examination of the new health technology

• Safety

• Effectiveness
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The 5 non-clinical domains include:  
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• Cost and economic evaluation

• Ethics

• Organizational impacts

• Social impacts

• Legal aspects

Spain released its Draft Royal Decree on the 12^th of August, which is open for comments until the 20^th of September, outlining how they will align with the Directive. This effort involves the Office for the Evaluation of the Efficiency of Medicines operating as a functional unit under the Spanish Agency of Medicines and Medical Devices (AEMPS).

In addition to joint clinical assessments in Europe, there will also be joint scientific consultations. The goal of this Directive is to reduce duplicate administrative work and remove barriers to innovation while aiming to improve patient outcomes.  

As these changes reshape the landscape, it's crucial for pharmaceutical and medical technology companies to adapt swiftly. Lyfegen can help you stay ahead with our cutting-edge solutions:
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- Navigate New Regulatory Requirements: Access our extensive Agreements Library, featuring over 5,000+ public drug pricing agreements and 20 pricing models, to ensure compliance with the latest HTA standards.

- Optimize Decision-Making: Utilize our Drug Contracting Simulator to create data-driven business cases and run real-time simulations that align with Spain's new HTA guidelines.

- Streamline and Automate Contracting: Our Rebate Analytics solutions automate rebate and refund calculations, ensuring accuracy, transparency, and a significant reduction in administrative burdens.


Book a demo with us today to explore how Lyfegen’s tools and expertise can support your business under Spain’s new HTA framework.
Book your demo here: https://www.lyfegen.com/demo

The news are out: we are immensely proud to be partnering with Johnson & Johnson to advance value-based healthcare and help patients around the world. We dived into a conversation with our CEO Girisha Fernando on why this partnership holds so much value for Lyfegen.


Girisha, why was the partnership with Johnson & Johnson such an important milestone for Lyfegen?

Girisha Fernando: Johnson & Johnson and Lyfegen share the same vision of sustainable & a value-based healthcare environment. Our goal is to help patients to receive the healthcare treatments they need and with this partnership, Lyfegen is proud to have been a key enabler for Johnson & Johnson and hospitals to deliver better health outcomes for patients.

How can this partnership be a blueprint for future collaborations?

Girisha Fernando: The increasing demand for healthcare measured against the limited financial resources is forcing the healthcare system to deliver innovative technologies to patients at sustainable costs. This can be done with value-based healthcare approaches and value-based agreements. The partnership between hospitals, Johnson & Johnson and Lyfegen shows how healthcare providers, manufacturers and an innovative tech company can deliver more value to patients whilst making efficient use of limited resources.

What would you suggest healthcare payers and hospitals to do if they are considering to implement value-based healthcare agreements with manufacturers?

Girisha Fernando: I believe it is important to focus on how to deliver better patient outcomes at lower cost. Value-based healthcare agreements can be used as a value-maximising method. It allows payers and hospitals to measure health outcomes and the adjacent cost to achieve these outcomes. Thus, hospitals can pivot on focusing their resources on value-adding healthcare treatments whilst addressing financial risk and uncertainty. It will take initial & minimal investment, but the return on investing in value-based healthcare and technology will be in the form of more value for money and better quality and patient health outcomes.

Why is Lyfegen the right platform for this?

Girisha Fernando: With over 120 value-based healthcare agreements running on the Lyfegen platform, we provide the necessary expertise, knowledge and technical competence to our customers. With these capabilities, we break down the complexity of implementing and managing value-based healthcare agreements. And lastly, we ensure that our customers can improve patient health outcomes by using value-based agreements at scale, efficiently.

Learn more about our platform by booking a demo today:

BOOK A DEMO TODAY

Barcelona, April 9, 2024

The Consortium of Health and Social Services of Catalonia has begun to work on value-based drug purchasing models by incorporating new tools for information management and negotiation with the pharmaceutical industry. This is an innovative project in collaboration with the health technology brand Lyfegen, which has developed the largest platform for managing public agreements in the world and a drug contracting simulator that allows for better deals by maximizing value in the purchasing process.

The goal of this innovative initiative is to increase the processes of value-based drug procurement, allowing CSC-affiliated health centers to focus on the evaluation of the clinical, economic, and social benefits that the drug can provide in relation to its cost.

For the design of these new procurement models, the "Lyfegen Agreements Library" database and the “Lyfegen Drug Contracting Simulator” were used, and work was done on the automation of administrative tasks and on improving interoperability among hospitals and health administrations. These tools allow the CSC to model various agreements and improve the drug management process in the central contracting office. The Health and Social Consortium of Catalonia thus becomes the first organization in Spain to incorporate these tools.

"From the Consortium, we are convinced that access to innovation and the sustainability of the health system relies on reaching innovative management agreements with pharmaceutical laboratories," says Josep Maria Guiu, director of the Pharmacy and Medication Area of the CSC. "The alliance with Lyfegen gives us a tool to work in this direction and to advance in the establishment of satisfactory agreements that facilitate access to innovation and contribute to the sustainability of the health system."

Girisha Fernando, CEO of Lyfegen, comments that "We are proud to help the Consortium lead access to innovation to improve patient care in Catalonia." "By using our advanced solutions, more than 100 health organizations throughout the region can research, model, and efficiently manage agreements, as well as value-based drug procurement," he adds.

“This allows professionals to really focus on what matters most: patient care.”

The collaboration with Lyfegen reflects the commitment of the Health and Social Consortium of Catalonia to value-based drug procurement and to access to pharmacological innovation, as well as the will to continue working for the implementation of solutions that ensure equity and sustainability of the health system.

The total contracting volume of the CSC, which acts as the purchasing center for the subsidized health sector of Catalonia, was 1.497 billion euros in 2023. Of this amount, 90% corresponded to medicines and 10% to sanitary products.

In recent years, the Consortium of Health and Social Services of Catalonia has incorporated social value aspects into the purchasing processes. For example, it has committed to ensuring that 100% of its drug and sanitary product tenders incorporate environmental clauses by 2024.

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About Lyfegen

Lyfegen is an independent provider of rebate management software designed for the healthcare industry. Lyfegen solutions are used by health insurances, governments, hospital payers, and pharmaceutical companies around the globe to dramatically reduce the administrative burden of managing complex drug pricing agreements and to optimize rebates and get better value from those agreements. Lyfegen maintains the world’s largest digital repository of innovative drug pricing models and public agreements and offers access to a robust drug pricing simulator designed to dynamically simulate complex drug pricing scenarios to understand full financial impact. Headquartered in Basel, Switzerland, the company was founded in 2018 and has a market presence in Europe, North America, and the Middle East. Learn more at Lyfegen.com.

About CONSORCI

The Consortium of Health and Social of Catalonia (CSC) is a public entity with a local and associative basis, founded in 1983, which has its origin in the municipal movement. The CSC, a reference to the sector and with a clear vocation for service, has as a mission: to promote excellent and sustainable health and social models to improve the quality of life of the people, offering services of high added value to its partners. CSC wants to be the main reference for knowledge and capacity for cooperation, influence and anticipation in the face of the new challenges of the health and social system. All CSC associates are public or private non-profit bodies. For more information, please visit https://www.consorci.org/el-csc/en_index

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Die Vertragssoftware von Lyfegen wird von Kostenträgern im Gesundheitswesen und führenden Pharmaunternehmen eingesetzt, darunter Novartis, Roche, MSD, Bristol Myers Squibb (BMS) und Johnson & Johnson.

NEW YORK/BASEL, 20. September 2022 /PRNewswire/ – Lyfegen, ein globales Healthtech-SaaS-Unternehmen, das den Übergang von volume-zu value-based Healthcare für hochpreisige Medikamente vorantreibt, gab heute eine überzeichnete Serie-A-Finanzierungsrunde über 8 Millionen Dollar bekannt, die vom Investmentfonds aMoon mit zusätzlicher Beteiligung von APEX Ventures und weiteren Investoren angeführt wurde.

Derzeit sind weniger als 2 % der Krankenversicherten, die Spezialarzneimittel benötigen, für 51 % der Arzneimittelausgaben verantwortlich. Die Kosten für Spezialarzneimittel in den USA laufen aus dem Ruder: Sie stiegen allein von 2020 bis 2021 um 12 % – und es gibt keine Anzeichen für eine Verlangsamung, denn es kommen immer mehr Zell- und Gentherapien auf den Markt. Infolgedessen wird Value-Based Contracting, die Nutzung wertorientierter Verträge, für die Kostenträger des Gesundheitswesens zu der entscheidenden Alternative, um nur für Medikamente zu zahlen, die tatsächlich wirken.

Bis 2025 werden die Nettoausgaben für Medikamente in den USA voraussichtlich bis zu 400 Milliarden US-Dollar betragen. Darüber hinaus kommen regelmässig neue Medikamente auf den Markt. Es fällt Pharmaunternehmen immer schwerer, sich mit den Kostenträgern auf kommerzielle Bedingungen zu einigen. Damit steigt die Gefahr, dass Patienten keinen Zugang zu lebensrettenden Therapien erhalten. Lyfegen hilft Regulierungsbehörden, Pharmaunternehmen und Kostenträgern bei der Einführung wertorientierter Zahlungsmodelle, indem sie den gesamten Prozess der Datenerfassung, Anonymisierung und Vertragsverhandlungen für alle Parteien digitalisiert. So kann die Preisgestaltung und Kostenerstattung für Medikamente vereinfacht werden.

„Wir freuen uns, diese Finanzierungsrunde bekannt zu geben und dieses Vertrauensvotum von aMoon, APEX und weiteren Investoren zu haben, die den Wandel im Gesundheitswesen verstehen und unser Bestreben um den Ausbau der Lyfegen-Plattform unterstützen", sagte Girisha Fernando, CEO und Gründer von Lyfegen. „Wir arbeiten derzeit mit führenden staatlichen Kostenträgern, Krankenversicherungen in Europa, den USA und dem Nahen Osten sowie mit einigen der weltweit grössten Pharmaunternehmen zusammen. Wir beabsichtigen nun, unsere Präsenz in den USA weiter auszubauen und Partnerschaften mit privaten und öffentlichen Krankenversicherungen einzugehen. Die Abkehr von der volumenbasierten Gesundheitsversorgung war noch nie so notwendig wie heute, und wir freuen uns, dass wir eine wichtige Rolle bei der Umstellung auf Value-Based Contracting spielen können."

„Lyfegen adressiert einen bedeutenden Marktbedarf in einer Branche, die sich dramatisch und schnell verändert, und wir sind begeistert, dass wir mit unserer Investition dazu beitragen können, ihre Anstrengungen zu unterstützen", erläuterte Moshic Mor, General Partner bei aMoon und ehemaliger Partner bei Greylock and Greylock Israel. „In Zeiten von Budgetdruck und Rezession im Gesundheitswesen braucht die Welt Lösungen wie die von Lyfegen mehr denn je. Wir sind stolz mit diesem erfahrenen Führungsteam zusammenzuarbeiten, das weiterhin den Zugang zu neuen Medikamenten verbessert, während es die wertorientierte Gesundheitsversorgung immer mehr zum Mainstream macht."

Informationen zu Lyfegen

Lyfegen ist ein unabhängiges, globales Softwareanalyseunternehmen, das eine wert- und ergebnisbasierte Vertragsplattform für Krankenversicherungen, Pharma- und Medizintechnikunternehmen sowie Krankenhäuser auf der ganzen Welt bietet. Die sichere Plattform identifiziert und operationalisiert wertbasierte Zahlungsmodelle kostengünstig und macht diese mit einer Vielzahl von realen Daten und maschinellem Lernen skalierbar. Mit der zum Patent angemeldeten Plattform von Lyfegen können Krankenversicherungen und Krankenhäuser eine wertorientierte Gesundheitsversorgung einführen und skalieren und so den Zugang zu Behandlungen, die Gesundheitsergebnisse der Patienten und die Kostenersparnis verbessern.

Lyfegen hat seinen Sitz in den USA und der Schweiz und wurde von Persönlichkeiten mit jahrzehntelanger Erfahrung im Gesundheitswesen, in der Pharmaindustrie und im Technologiebereich gegründet, um den Übergang von der volumenbasierten und kostenpflichtigen Gesundheitsversorgung zur wertorientierten Gesundheitsversorgung zu ermöglichen. Weitere Informationen finden Sie auf www.lyfegen.com.

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Pressekontakt: yael@gkpr.com

Ansprechpartner für Investoren: investors@lyfegen.com

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EGK nutzt die Lyfegen-Plattform, um komplexe Preismodelle für die On- und Off-Label-Verwendung von mehr als 80 Medikamenten zu verwalten.

Basel, Schweiz - 29. November 2022 - Lyfegen, ein globales Healthtech-SaaS-Unternehmen, das den weltweiten Übergang von einer volumen- zu einer wertbasierten (value-based) Gesundheitsversorgung für hochpreisige Arzneimittel vorantreibt, gab heute bekannt, dass die EGK-Gesundheitskasse sich seinem Portfolio von Versicherungspartnern anschliesst, um alle ihre Verträge zur wertbasierten Preisgestaltung für hochpreisige Arzneimittel effizient, sicher und transparent auszuführen.

Die Schweiz, mit den vierthöchsten Arzneimittelausgaben pro Kopf, gab in den ersten neun Monaten des Jahres 2022 8 Milliarden Franken (8,1 Milliarden Euro) für Medikamente aus, die für bestimmte Krankheiten verschrieben wurden. Um die hohen Arzneimittelausgaben zu bekämpfen, hat die Schweiz in den letzten fünf Jahren eine wachsende Zahl von Rabattmodellen für den On- und Off-Label-Einsatz von Medikamenten eingeführt. Die Komplexität der Preismodelle führt jedoch dazu, dass die Versicherer Millionenbeträge für die Überwachung und Beurteilung der Preismodelle ausgeben, was zu entgangenen Rabatten in zwei- bis dreistelliger Millionenhöhe führt.

Mit der Software von Lyfegen kann die EGK mit minimalem Aufwand und maximaler Transparenz Rabatte aus 141 Medikamentenpreismodellen von 32 Herstellern identifizieren und einfordern. Dazu gehören Fälle von seltenen oder chronischen Krankheiten, vielversprechende Therapien, die ausserhalb der zugelassenen Indikation eingesetzt werden können, oder neue Medikamente, die in der Schweiz noch nicht erhältlich oder zugelassen sind. Die Plattform von Lyfegen adressiert die Bedürfnisse der Schweizer Krankenversicherer nach Kosteneffizienz und Digitalisierung. Sie hilft, bestehende Komplexitäten im System zu lösen und wirkt hohen Versicherungsprämien entgegen.

„Wir freuen uns, die EGK zu unterstützen und eine aktive Rolle bei der Bewältigung der zunehmenden Komplexität von Medikamentenpreismodellen zu übernehmen, um den nachhaltigen Zugang zu innovativen Medikamenten und Therapien in der Schweiz zu unterstützen“ sagte Nico Mros, CXO und Mitgründer von Lyfegen. „Indem wir uns darauf konzentrierten, die Implementierung der Plattform so einfach wie möglich zu gestalten und auf die EGK einzugehen, konnten wir schnell Ergebnisse präsentieren und die Zusammenarbeit erfolgreich starten!“

"Mit der Lyfegen-Plattform baut die EGK ihren Fokus auf Nachhaltigkeit und Effizienz zum Wohle ihrer Versicherten weiter aus", sagt Carolina Pirelli, Leiterin Leistungen und stv. Geschäftsleiterin bei der EGK. "Die immer grösser werdende Zahl von Preismodellen für Medikamente stellt die Versicherer vor Herausforderungen in Bezug auf Ressourcen und Prozesse. Mit der automatisierten Verarbeitung von Preismodellen über die Lyfegen-Plattform können wir unsere aktuellen Anforderungen perfekt erfüllen und sehen uns mit der Flexibilität, dem Fokus und dem Verständnis von Lyfegen in guten Händen."

Über Lyfegen

Lyfegen ist ein globales SaaS-Analyseunternehmen im Gesundheitsbereich, das eine Plattform für wert- und ergebnisbasierte Verträge für Medikamente, Therapien und Medizingeräte anbietet.

Krankenversicherungen, Pharma- und Medizintechnikunternehmen sowie Spitäler nutzen die sichere Plattform für Tausende von Preismodellen in der Schweiz, Europa, dem Nahen Osten und Nordamerika. Die Lyfegen Plattform unterstützt die Verhandlungen und ermöglicht die automatisierte Ausführung von wertbasierten Preismodellen durch die Analyse von real-world Daten durch intelligente, lernfähige Algorithmen.

Weltweit renommierte Krankenversicherungen, Spitäler, Pharma- und Medizintechnikunternehmen haben die zum Patent angemeldete Plattform von Lyfegen bereits implementiert, um wertbasierte Preismodelle für Medikamente, Therapien und Medizingeräte zu skalieren und damit den Zugang zu Behandlungen sowie Therapieergebnisse für Patienten zu verbessern.

Lyfegen wurde von Personen mit jahrzehntelanger Erfahrung in den Bereichen Gesundheitswesen, Pharma und Technologie gegründet und leistet Pionierarbeit bei der Umstellung von der volumenbasierten und kostenpflichtigen Gesundheitsversorgung auf die wertbasierten Gesundheitsversorgung. Weitere Informationen finden Sie unter www.lyfegen.com.

Über die EGK-Gesundheitskasse

Die EGK-Gesundheitskasse ist ein KMU-Krankenversicherer mit Sitz in Laufen (BL). Die EGK-Gruppe umfasst die EGK Grundversicherungen AG (Grundversicherung nach KVG), die EGK Privatversicherungen AG (Zusatzversicherung nach VVG) sowie die EGK Services AG (Verwaltung). Sie versichert schweizweit rund 100'000 Personen in der Grundversicherung, 80% von diesen verfügen auch über eine EGK-Zusatzversicherung.

Natürlichkeit und Nachhaltigkeit gehören zur Werthaltung der EGK. Sie gilt als Pionierin beim uneingeschränkten Zugang zu exzellenter Komplementärmedizin. Sie lanciert und unterstützt in der ganzen Schweiz Aktivitäten zur natürlichen Stärkung der Gesundheit.

Read on PR newswire in German

Read on PR newswire in English

In light of today’s anticipated press release and exclusive article with AXIOS, we would like to extend a heartfelt thank you to our investors, customers, and team for sharing our vision to transform the healthcare system, helping patients to receive the healthcare treatments they need. The closing of our oversubscribed series A, led by aMoon Fund with additional participation from APEX Ventures and others, marks an important milestone.

Skyrocketing drug prices–especially for high-cost specialty drugs like cell and gene therapies–are accelerating the demand for value-based drug pricing. The move away from volume-based healthcare has never been more needed, and we are happy to play an important role in the shift to a value-based future.

With the $8 million in funding, we will expand our presence in Europe and the U.S. to increase drug affordability for more customers and, more importantly, more patients.

Together, we save lives.

Read the official Press Release

Read the Exclusive article with AXIOS

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Girisha Fernando
CEO & Founder[/caption]

Join in from anywhere in the world for two hours of incredibly interesting presentations by industry experts all around the topic of value-based healthcare.

At this DayOne Experts event, organized in close collaboration with Deloitte, industry experts will give an overview of where the pay-for-performance discussion in healthcare stands; possible solutions; and show how value-based healthcare could, should, and will impact the industry.

During the webinar, which will include deep dive sessions, we will seek answers to some of the most pressing questions: “How to define the value of a health outcome; how to capture it? Check out san diego boudoir photographer. In which areas of intervention is the value-based healthcare approach feasible; where would it be desirable? To what extent will value-based healthcare create new opportunities and accelerate innovation?”

See the full program & sign-up

To guarantee our users happiness when working with our software, we are welcoming a brand-new quality specialist at Lyfegen: Liubov Buzila has joined the team and will keep an eagle eye on our platform to ensure everything runs like clockwork.

We sat down with Liubov to learn about her experience, her goals and her aspirations.

Hello Liubov, and welcome to Lyfegen! Please tell us a little about yourself: Where are you from, and what’s your educational and professional background?

I’m Ukrainian, but I moved to Romania two years ago and currently live in the city of Iași. I have a bachelor’s degree in applied linguistic, and my first job as a QA engineer was five years ago during my fourth year at university. I have worked in this field ever since.

What excites you about being a QA engineer?

Being a QA engineer is always challenging, and that’s what I love about it. Every day I deal with a lot of things that force me to think outside of the box. A tester is not only a person who has to find problems in the system, but also a person who takes responsibility for the system’s quality; this is what makes me super excited about my work – I enjoy improving our software for the better.

Why did you decide to join Lyfegen?

I am always striving to learn something new, and Lyfegen’s startup spirit is a great fit for that. I have tested products in different fields, but I have never worked in the healthcare industry before. Personally, I think it’s a great opportunity to see how the system works from a new perspective and to gain new experience.

What is something you want to learn or improve this year?

QA is a field where you are constantly learning something new, starting with technologies used in the product and ending by gaining new soft skills as part of an amazing team. The healthcare industry is new territory for me; I’m looking forward to exploring it and gaining expertise.

How will your know-how help to improve our customers’ experience of the Lyfegen platform?

My main goal is to improve the quality of the Lyfegen platform and deliver a highly reliable and convenient product to our customers. The rule is very simple: less bugs, happier customers!

Let’s get personal: What are your favorite things to do in your free time?

I love to cook! Whenever I get any free time, I find new recipes and try to impress my family. I also like listening to music. Music is the thing that helps me to relax and forget about my troubles. And, of course, I like travelling – I have been to 20 countries already, and I look forward to exploring more.

Is there anything else you are looking forward to outside of work this year?

Nothing specific, just enjoying my free time and travelling.

We are happy to have you with us, Liubov!

MEET THE LYFEGEN TEAM

Last week Lyfegen announced exciting news! Out of hundreds of start-ups, Lyfegen is among the top 10 selected to join one of Europe’s most innovative acceleration programs: InnoPeaks by Groupe Mutuel.

The news is taken with much excitement by Lyfegen’s co-founder, Michel Mohler, who briefly explains why being selected for this three month program by one of Switzerland’s leading health insurance companies is a great achievement for Lyfegen.

Hi Michel, can you give us a little more insights on the InnoPeaks program?

InnoPeaks is a business-focused acceleration program that focuses on challenging, enabling, growing, and scaling a business through workshops, mentorship, networking, and implementing proof of concepts. Groupe Mutuel, one of Switzerland’s leading health insurances, organizes this program. Their specific goal is to drive innovation in the two topics which support their core business: healthtech and insuretech.

Lyfegen is amongst only 10 startups that have been selected out of hundreds. What is Groupe Mutuel’s interest in having you on board?

Lyfegen, being one of Switzerland’s most innovative start-ups, is solving a crucial challenge healthcare – improving health outcomes for patients. We do this with our ground-breaking technology, working together with health insurances to give patients faster access to the medicine they need. Considering high-cost, personalized and potentially curative drugs, the prices of drugs need to become dynamic and depend on how well they work for patients. This also known as value-based contracting. Until recently, we have seen mostly Pharma Companies advocating for such pricing models. Engaging with a leading health insurance with our platform, we will achieve to bring such models to life in Switzerland, for Swiss patients.

What does Lyfegen want to achieve by being part of this program?

Switzerland's Federal Council (“Bundesrat”) addresses value-based contracting as one of the key solutions to achieve a more sustainable Swiss healthcare system. Our goal is to speak and learn from other startups, talk to decision makers at Groupe Mutuel, exchange thoughts and inspire Groupe Mutuel. As a result, we want to understand the perspective of health insurances and engage in a proof of concept.

We look forward to evolving with InnoPeaks, Groupe Mutuel and the other Start-ups. The team will be live-covering the InnoPeaks accelerator program in October, so stay tuned for more!

READ MORE ABOUT INNOPEAKS

At Lyfegen, we live by the highest quality standards, continuously improving as we move forward with facilitating value-based healthcare agreements for a fast & sustainable access to innovative therapies.

What is ISO 9001:2015?

The ISO 9001:2015 standard provides guidance and tools for companies and organizations who want to ensure that their products and services consistently meet customer’s requirements with quality being consistently improved.

This standard sets out the criteria for a quality management system used by many organization, large and small. Using ISO 9001:2015 helps ensure that customers get consistent, high quality products and services.

What this mean for Lyfegen?

At Lyfegen, we live by the highest quality standards, continuously improving our solutions & processes, as we move forward with the operationalisation of value-& data driven contracts for a fast & sustainable access to innovative therapies. In turn, this will benefit patients worldwide!

We are audited yearly by a third-party to keep our ISO status up to date.

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“I am responsible for building the right products, and for building the products right.” Says Antti Hietala. Welcome to the Lyfegen Team!

As we embark on a new year, the great news start rolling in: Lyfegen welcomes its newest star, Antti Hietala, who takes on the key role of Product Owner.

As Antti arrives for his first day, Lyfegen’s CEO Girisha Fernando gives us his thoughts:
“Antti's excellent skills to think ahead and pull together industry, customer and technical perspectives to building a solid and ever-evolving product roadmap fills me with excitement, and will strengthen Lyfegen’s value for our customers even further. We are delighted to welcome Antti, a proud family man with values aligned with Lyfegen's values.”

We sat down with the ski-loving Product Owner to get a little more insight to who he is and what he will be doing at Lyfegen.

Hi Antti, tell us a little about yourself: where are you from and what is your professional background?

I come from the Arctic Circle. I grew up under the northern lights in a small town in northern Finland. I studied linguistics and computer science. My passion for content and technology led me to a career in technical writing. I wrote documentation for newspaper advertising systems and for financial asset management software.
Prior to joining Lyfegen I was the lead Product Manager at Magnolia where I built a content management solution. I’m a certified Scrum Product Owner and have worked with Product Managers and user experience designers in the past.

Why did you decide to join Lyfegen?

Lyfegen is my first venture into healthcare technology and it has an important mission: helping patients access innovative therapies by driving value-based healthcare. Removing obstacles that keep patients from getting the treatment or drugs they need is a high-level motivator. I’m also optimistic in our ability to make a big difference in the user experience of health technology and software.
I wanted to apply my product owner skills to an industry that is completely different from where I have worked before. Some say that it’s good to step out of your comfort zone and learn something completely new. The healthcare field is an exciting new challenge for me. I am thankful to the Lyfegen team for their confidence and trust that solid product management skills are universal and that I will apply them for a meaningful purpose.

You are joining Lyfegen as a Product Owner! In simple terms: what will you be working on?

I’m excited about joining Lyfegen! The team is packed with motivated and genuinely passionate people. We are on a path to build the most innovative contracting platform in the healthcare industry.
As Product Owner (PO) I am responsible for building the right products, and for building the products right. Concretely, this means talking to customers to understand their needs. I will define the product together with the Lyfegen team, translate the customer needs into features in our platform, together with our tech team.
My role has a strong outward-facing component. It’s critical for me to be in close contact with customers in order validate decisions quickly and build the right thing. My goal is to make our software valuable for our customers.

What are your next personal goals with Lyfegen?

Learning more about the healthcare and pharmaceutical industry is my first personal goal. There are so many new terms and abbreviations coming my way every day. It’s like the field has a language of its own.
On the product side, I’m very focused on optimizing the product-market fit. This means, finding the key features that really fulfill user needs and then amplifying those features in the product. I want to see users become fans! That’s a sign of a great product-market fit to me.

Enough about work! What passions do you have outside of Lyfegen?

I love to ski in the winter. I’m lucky to live in beautiful Switzerland where the Alps provide ample opportunity to hit the slopes. In the summer I do fly fishing in the Black Forest region of southern Germany or in Alsace, France. I’m also an avid pizza chef, forever improving my home-pizza game with the ultimate goal of authentic Neapolitan pie.

We are proud to welcome Antti to the Lyfegen team!

MEET THE LYFEGEN TEAM