By Susan E. Campbell
Whenever people take medicine, there is a chance there was an influencer behind the scenes who worked to make the drug available to insured patients and at the “right” price.
Peregrine Market Access is such an influencer, an international consulting firm that recently opened an office in Saratoga Springs and made it the new headquarters.
The field of pharmaceutical market access ensures that patients have rapid and sustained access to a brand of drug by advocating for that product and recommending a price at which insurers, confident of the patient’s improved health outcome, will pay for it.
Two of the firm’s three partners, founder/president John Guarino in the Thousand Oaks, Calif., office and Scott Neverett, who directs human resources from 125 High Rock Ave. in Saratoga Springs, were long time associates at Palio, a health care marketing agency that closed its Broadway office in 2016.
A third partner and former peer of Guarino’s from AmGen runs an office in Paris and helps European pharmaceuticals enter the American market.
“Palio focused on marketing health care to physicians, but Peregrine focuses on the payers, who are the insurance companies,” said Neverett.
Neverett had hired Guarino while at Palio to start a market access arm at that agency.
Peregrine’s consulting services draw from an understanding of the market landscape, brands, and target customers of biotech and pharmaceutical manufacturers, according to the partners.
“Our market access staff comes from within pharmaceuticals, not ad agencies. Our communications staff comes from within advertising, not pharmaceutical companies,” said Neverett.
Guarino said there are eight ad agencies in Saratoga in the health care field, all vying to provide a marketing skill set to pharmaceutical firms that the client company is either too small or does not have the desire to hire in-house. Peregrine’s staff of 35 has different backgrounds and knowledge that help win clients in a competitive field.
“We win 80 percent of our pitches and the average is 20 percent,” said Guarino. “By talking about our capabilities and presenting our expertise, we went from a small start-up to multiple offices three years later.”
The newest office in Saratoga Springs was opened in June and celebrated the signing of “two significant contracts,” he said.
Peregrine consults for pharmaceutical companies large and small.
“Smaller companies don’t have big pharma resources, but we can help them determine which markets to reach,” Guaraino said. “For example, we may be able to reach three-quarters of the market for their medicine for a fraction of the cost of reaching 100 percent.”
Insurance companies, as the payers, decide if they will make a product available, then determine how much they will pay and how much they will charge the patient. Guarino said that the time to bring Peregrine’s proficiencies in front of payers is before the insurance carrier decides not to allow access of the pharmaceutical company’s product to its insureds.
When pitching a client’s medical product to payers, Guarino said his firm has become expert at differentiating between, and explaining to decision makers, the cost versus the value of a product.
“There is a cure for muscular dystrophy that costs $3 million,” he explained. “The insurance company says it cannot afford that and remain in business, but actually it is more affordable than paying $10 million in medical care over the afflicted child’s lifetime.”
Finding that “right price” where manufacturer and payer make money can be “crazy, expensive thing in uncharted waters,” Guarino said.
“Ultimately we help sick people by showing what the medicine is worth not only in terms of human life, but what may happen to an insurer’s bottom line,” he said. “We have developed some proprietary and very innovative digital decision-making programs and artificial intelligence to help payers assess their risk at certain pricing levels.”
Guarino said that medicine represents only 12 percent of all health care costs, and that “there are no hearings on Capital Hill on the other 78 percent. If medical costs doubled tomorrow, health care premiums would only go up 12 percent,” he said.
But the pharmaceutical companies such as the ones Peregrine represents are the “scapegoats right now” of higher drug costs, Neverett said. Consider the epipen, for which rising costs have caused a public furor.
“Demand drove up the cost of the epipen,” Guarino said. “Now the insurance company has to buy more, so they are asking more money out of the patients. The insurance company says that sick people have to pay their fair share,. I said, ‘I thought the concept of health insurance is that everybody pays a little.’”
Guarino said “every insurance company in America is making a profit.” While reform is needed in “some hybrid form, a $3 trillion industry is not going to go away.”
Should a single-payer system become a reality, “Peregrine will become the people who talk to that one company,” he said.
Peregrine not only finds itself at home in Saratoga Springs, but the partners “love this community,” according to Guarino.
Favorite community involvements include helping Saratoga WarHorse financially and participating in work days for the nonprofit . Peregrine also supports B.E.S.T., the Backstretch Employee Service Team serving workers behind the scenes at all of New York’s racetracks.
“Migrant workers have been a part of my life in California,” Guarino. “Working conditions are poor, and assisting them is not just a matter of giving money or buying food or supplies.”
For more information, visit www.peregrinemarketaccess.com.