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Evidence-Based Communication to Improve Payer Coverage

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Client Profile

Large Diagnostics

Key Stakeholders

Clinical Marketing, Government Affairs, Medical Affairs

Asset

Launched

Disease Area

Gastroenterology

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Client Profile

Large Diagnostics

Key Stakeholders

Clinical Marketing, Government Affairs, Medical Affairs

Asset

Launched

Disease Area

Gastroenterology

Situation

A large diagnostics company was launching a diagnostic panel used across multiple clinical settings and was beginning to encounter payer resistance.

While the technology was well established, coverage decisions varied by payer and were increasingly influenced by how clinical value was articulated.

The client engaged Alkemi to develop an evidence-based communication tool that could be used in payer discussions to support broader coverage across the portfolio.

Approach

1. Reviewed the clinical and economic evidence supporting the diagnostic panel to identify value drivers relevant to payers.

2. Conducted interviews with payer and health plan decision-makers to understand current perceptions, concerns, and evidence expectations.

3. Collaborated with cross-functional teams to translate insights into a clear value narrative and communication tool for payer engagement.

The focus throughout:

Ensure payer discussions were grounded in evidence that aligned with real decision criteria.

Deliverables

1
Literature review synthesizing evidence-based value messages relevant to payer decision-making.
2
Payer interviews to clarify coverage drivers and evidence gaps.
3
Evidence-based value brief designed to support consistent payer discussions.
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6

Impact

""Thanks again for pulling together a great team, appreciate it a lot. Hope this is one of many engagements." - Senior Director, Marketing

Improved Coverage Conversations:

Teams entered payer discussions with clearer, more consistent evidence-based messages.

Stronger Value Articulation:

The client improved how clinical value was framed across different payer audiences.

Increased Coverage Confidence:

The communication tool supported more effective payer engagement and coverage discussions across the portfolio.

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