Optimize Your Commercial Strategy With Claims Data

Specialty medicines now account for 55% of U.S. drug spending, more than double their share in 2011.¹ As launches get narrower and more competitive, the teams that win are the ones that can back a decision with data specific enough to defend it in a publication or payer conversation. 

Medical Affairs and Health Economics and Outcomes Research (HEOR) teams have built their work on closed claims data for years. It’s how they generate evidence that holds up. Commercial teams now need the same rigor in their own work. Identifying a narrower market, building a defensible case for it and targeting with real precision all require the kind of evidence closed claims data has long delivered in HEOR. 

Closed claims data doesn’t serve every team the same way, though. What a market access lead needs from it looks nothing like what a sales operations analyst needs. This article walks through what closed claims data gives each team. 

The shift to specialized therapies

Over the past decade, drug development has shifted toward specialized therapies for conditions like cancer, autoimmune disease, and rare disorders. Treatment is increasingly built around narrow patient populations, which means commercial strategy has to get more targeted. A one-size-fits-all launch plan doesn’t hold up when the addressable population is a few thousand patients instead of a few million. 

Key trends:

• Specialty medicines already account for more than half of U.S. drug spending and are projected to exceed 55% of total spending in leading developed markets by 2028.¹ 

• The average cost to develop a drug from discovery to launch reached $2.67 billion in 2025, up from $2.23 billion a year earlier, raising the return each launch must generate. ² 

• Oncology remains the largest area of biopharma R&D at roughly 45% of industry spending, keeping competition in specialty categories intense even as pipelines concentrate in a few high-value therapeutic areas. ³ 

The pressure is clear: commercial investment has to work harder, and it has to be aimed with precision. The differentiator is no longer access to data. It’s how quickly an organization can turn data into evidence that holds up in a payer conversation, a launch plan or a leadership review. 

How closed claims data supports the full product team

Real-world data changes how life sciences organizations understand patient journeys, treatment pathways and cost of care. But different commercial teams need different things from it. Closed claims data, representative across commercial, managed Medicaid and Medicare Advantage populations, supports a different kind of work for each: 

• Market access teams use it to build the comparative effectiveness, health care resource utilization and budget impact analyses behind payer value dossiers, and to compare treatment patterns in populations with and without coverage when shaping payer strategy. 

• Marketing and brand teams use it for epidemiology-based market sizing, mapping the diagnosed, eligible and treated population, and patient segmentation that sharpens positioning before a launch reaches the field. 

• Medical affairs and HEOR teams run comparative effectiveness and disease burden studies across payer types, generating the evidence base behind both publications and payer conversations. 

• Patient services teams model persistence and discontinuation patterns to flag where patients are falling off therapy, so teams can intervene before a patient switches or stops. 

• New product planning and portfolio strategy teams use the same population and treatment pattern data to size the opportunity and build the early revenue case for a pipeline asset. It also supports indication expansion after launch: comorbidity patterns and treatment overlap in the claims population point to where a current asset may have a credible case in a new indication. 

The power of closed claims data

Closed claims data offers a full view of a patient’s care journey: diagnoses, procedures and costs, tied together over time. It’s used to create defensible evidence that can stack with other data assets that are faster or more expansive.  

Inovalon’s closed claims draw on nationally representative sourcing from more than 160 primary sources across all 50 states, so the foundation is traceable to its origin. Four properties are what let it capture a full patient story: 

• Post-adjudication truth: Closed claims reflect the final paid claim. The negotiation between provider and payer is already settled, so what you see is what was actually rendered and paid. 

• Continuous enrollment creates real denominators: Known enrollment windows mean prevalence and incidence rates are calculated against a real population, so the numbers hold up to scrutiny. 

• Tracking across coverage and care transitions: Patients can be followed as their coverage changes, revealing persistence, switching and drop-off that a single-payer or clearinghouse view misses. 

• NPI-level provider attribution across sites of care: Care can be attributed to specific providers across the settings where it happens, so targeting and referral analysis reflect the real provider’s ecosystem. 

In short, closed claims provide a traceable, defensible foundation for the rest of the data stack. 

From data to evidence: two speeds, one in-house team

Having the right data is only half the equation. The harder problem for many commercial and market access teams is capacity: the internal analytics queue is already committed, the launch or review calendar will not move, and a defensible answer is still due on time. Access to a dataset does not solve that. A team can. 

That is where Commercial Analytics comes in. Part of Inovalon’s Outcomes & Evidence Solutions, Commercial Analytics is run by an in-house group of HEOR, epidemiology and data science experts who turn Inovalon’s primary source data into presentation-ready evidence, documented with clear methods. It runs at two speeds, from the same team, on the same foundation. 

Strong primary source data is the foundation. What gets added is a team that knows that data deeply and can translate it into clear, defensible answers for decision-makers.

The path to strategic growth

Strong commercial strategy starts with data specific enough to act on. Real-world data and analytics help life sciences teams find real opportunities, sharpen how they engage providers and make the case for what sets their brand apart. Request a walkthrough today. 

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Inovalon and design®, Inovalon® are trademarks of Inovalon, Inc.

1. CarelonRx, “Specialty Drug Growth is Here to Stay” (2025), citing IQVIA projections that specialty medicines will represent 43% of global spending and more than 55% of total spending in leading developed markets like the United States by 2028; specialty drugs already account for at least half of U.S. pharmaceutical spending in recent years. 
2. Deloitte, “Measuring the Return from Pharmaceutical Innovation” (16th edition, 2026): average cost to develop a drug from discovery to launch grew to $2.67 billion in 2025, up from $2.23 billion in 2024. 
3. Catalyst Clinical Research, “Oncology Drug Development Trends” (2026): Oncology accounts for up to 45% of the biopharmaceutical industry’s annual R&D spend and remains the largest therapeutic area in drug development.