Finding physicians who treat ultra-rare disease

An oncology biopharma company struggled to identify every physician treating patients with an ultra-rare disease, even with some physician data from another provider, needing comprehensive market intelligence for this small patient community. The team used ClaimsMx — comprising commercial, Medicare, Medicaid, Medicare Advantage, federal program, and other payor sources — to pull National Provider Identifiers associated with the relevant ICD-10 diagnostic codes. This surfaced "15 net new physicians" not previously identified, each with "sizable revenue potential" in the ultra-rare disease space, and the company is now exploring further analyses like patient journey mapping and referral patterns.

The customer is anonymised in Definitive Healthcare’s own case study — not withheld by us.

Definitive Healthcare is a claims and provider-reference data platform used by pharma commercial teams for go-to-market planning and sales targeting.

This sits in the Data Providers stage of the AI use-case lifecycle: Named examples from the real-world-data, claims and competitive-intelligence providers pharma AI systems are trained on, benchmarked against, or run inside of.