Combining reliable statistical and econometric techniques with comprehensive knowledge of the market.

Experts at Monument Economics Group have a thorough understanding of the healthcare sector, including its unique institutional structure, complex market dynamics, and regulatory environment. Our in-depth industry knowledge covers a wide range of topics, including managed care contracting, generic competition, patent infringement, market allocation, vertical restraints, the Hatch-Waxman Act, the pharmaceutical supply chain, pharmacy benefit managers, Medicare, and Medicaid.

Our experience in healthcare economics, combined with our sophisticated capabilities in collecting, processing, and analyzing large databases of insurance claims, medical records, third-party data, FDA reports, and clinical trials, allows us to provide critical assistance to our clients in navigating healthcare disputes.

Monument Economics Group’s expert analyses are bolstered by our ability to combine reliable statistical and econometric techniques, honed across decades of experience, with comprehensive knowledge of the healthcare market.

Experts at Monument Economics Group also leverage in-depth knowledge of the healthcare industry and statistical expertise to provide consulting services and expert testimony in disputes involving allegations of inappropriate denial of claims or fraudulent billing practices.

Providing clients with complex analyses, consulting services, and expert testimony in a variety of contexts, including:

  • Healthcare Competition
  • Hospital Mergers
  • Government Inquiries
  • Data Analytics
  • Vertical Restraints
  • Product Liability
  • Healthcare Competition

    Experts at Monument are often asked to provide testimony in antitrust litigation concerning healthcare markets. Our experts analyze whether prices paid for medical procedures and pharmaceutical products were impacted by anticompetitive conduct in order to understand the counterfactual world in which the alleged misconduct did not occur. Anticompetitive conduct in healthcare markets manifests itself in many forms, including monopolization, tying, bundling, price-fixing, market allocation, pay-for-delay/reverse payments, product hopping, intellectual property disputes, and violations of the Hatch-Waxman act.

    The significant price differential between brand name drugs and their generic equivalents creates an incentive for competitors to conspire to retain the surplus that would otherwise be achieved by consumers. Experts at Monument Economics Group have analyzed the markets for numerous brand name and generic pharmaceuticals. Our expertise includes claims of pay-for-delay agreements, whereby generic competitors are paid by the brand name manufacturer to delay market entry.

    Experts at Monument have experience analyzing anticompetitive conduct at both the direct and indirect purchaser levels. Our experts have a comprehensive understanding of distribution chains and pass-through economics. Our empirical analyses of downstream markets are tailored to fit the complexities of the industry at hand. We have extensive experience measuring pass-through and indirect overcharges incurred by downstream payors using sound econometric and statistical methods. Experts at Monument also have experience using large claim-level databases from hospitals, insurers, and pharmacy benefit managers to identify downstream payors based on purchasing records. Experts at Monument are adept at dealing with the complexities of claims data, including the application and allocation of rebates and chargebacks.

    Hospital Mergers

    Monument has extensive experience providing consulting services and expert testimony regarding the competitive effects of horizontal and vertical mergers and joint ventures across the healthcare sector. With a thorough understanding of the healthcare industry and its regulatory framework, our team of economists are able to tackle the complex empirical questions often raised in hospital merger reviews by providing analyses for assessing competitive effects, including matters of quality of care, risk sharing, and efficiencies.

    As part of our assessments of mergers in the healthcare sector, experts at Monument Economics Group analyze market factors, apply relevant economic theory, and identify and assimilate the key data sources in order to define the relevant product and geographic markets at issue, evaluate the presence of competitive constraints on entry and expansion, and consider the impact of insurance and regulatory oversight on market dynamics.

    Government Inquiries

    Experts at Monument can provide insights and empirical analysis on matters that are of interest to the Federal Government.

    With a detailed understanding of econometric methods and healthcare market dynamics, our experts can evaluate policy decisions and support government investigations using healthcare data (including databases maintained by hospitals, drug manufacturers, pharmacy benefit managers, health insurers, and the Centers for Medicare and Medicaid services) and economic theory. Our analyses can be used to quantify damages or demonstrate liability in litigation contexts or investigations involving government entities.

    Data Analytics

    One factor in Monument’s ability to effectively deliver actionable insights to our clients is the deep understanding of the diverse and complex sources of healthcare data that our team of economists and consultants possess. This includes a variety of claims datasets for healthcare services and pharmaceuticals maintained by insurers, hospitals, and pharmacy benefit managers.

    Monument also has experience analyzing up-stream sales data from both brand and generic pharmaceutical manufacturers. In addition to our analysis of proprietary claims and sales datasets, our team has extensive experience with a wide array of publicly available data that are maintained by the Federal Government and private companies. These data cover topics such as Medicare spending, formulary placement, hospital costs and revenues, and pharmaceutical reference prices (e.g., WAC, AWP).

    To read more about MEG’s experience and expertise in the area of data analytics, click here.

    Vertical Restraints

    Vertical restraints are restrictions or limitations imposed by firms at one level of the production chain on firms located at another level of the production chain. Allegations of vertical restraints are common in healthcare settings and typically occur when payors negotiate terms with healthcare providers that limit another payor’s ability to compete on the basis of price.

    Experts at Monument Economics Group have experience analyzing payor contracts to assess claims of exclusive dealing with the technical and analytical expertise required to measure the potential impact on market output and consumer prices.

    Product Liability

    In matters involving product liability, experts at Monument Economics Group provide testimony and statistical modeling and analyses related to damages issues that are uniquely tailored to the complexities of the healthcare sector.