The evidence case that moves a specific payer

Coverage advocacy fails when it argues in general. This engagement starts with a per-payer evidence gap analysis covering the payer's current policy position, the criteria their last review applied, and the specific gaps between those criteria and your evidence base. Then we build the instrument that closes the gap, whether a reconsideration dossier, a coverage dossier, or targeted payer letters, drafted against that payer's own criteria and language.

Long generic value dossiers go unread. Payer-specific, criteria-matched, tightly cited arguments get meetings. We build the second kind. The pipeline assembles the evidence; a senior market access expert decides how to argue it and reviews every page a payer will read.

What lands in your inbox

Per-payer evidence gap analysis across your priority payer set
Reconsideration or coverage dossier for the target payer, drafted to their criteria
Evidence package assembled from the verified ledger and literature map
Senior market access review of strategy and tone before anything reaches a payer
Submission-ready formatting for the payer's actual review process

Start with the gap analysis. Add letters or a dossier where they pay off

Step one

Evidence gap analysis

Every payer in your set, scored against its own coverage criteria, with the specific gap named. Up to ten payers.

$3,000as a landscape add-on

$5,000standalone

Step two

Payer letters

Three to five page letters to a payer's medical director and coverage team, built from the gap analysis and the evidence that answers it.

$2,000per payer

Where it decides coverage

Payer dossier

The full reconsideration or coverage dossier for one payer, criteria-matched, with senior review before submission. The evidence package is built once, so each additional payer on the same product costs less.

$10,000first payer

$6,000each additional

Rebuilding a payer dossier at senior hourly rates runs $24,000 to $36,000 before strategy. Praxa's price holds because the evidence assembly rides on the pipeline while the strategy and the payer-facing judgment, the part that decides outcomes, get the expert hours. Every citation traces to the ledger, so a payer reviewer who checks your references finds exactly what the dossier claims.

Asked and answered

Which payers should we target first?

The gap analysis answers that empirically, showing where your evidence already meets criteria, where one study closes the gap, and where the case is premature. Sequencing becomes a finding.

Do you submit to the payer for us?

We prepare the submission-ready dossier and coach the submission. Where a payer relationship or society channel matters, we work alongside your team or a partner boutique that holds the relationship.

What if the honest answer is that our evidence is not ready?

Then the deliverable says so, with the specific evidence that would change the answer. That memo routinely saves clients a failed submission and a year of payer goodwill.

Ready to scope it?

Thirty minutes fixes the question, the deliverable, and the price. Kickoff within days of signature.

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