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Market access – looking back

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Market access is complicated. Multifaceted, multi-discipline, multidimensional, multi-stake-holder, all these multiples make Market Access one of the most challenging and important areas in pharma right now. 

No-one could disagree with that. Getting Market Access wrong can be disastrous. Promoting a brand to a prescriber who can’t switch because the product has not been approved by payers is a waste of share of voice. The communication of price efficiency and clinical effectiveness to the payer is crucial.

How can one be certain of getting it right?

We think part of the answer lies in looking back. Many of the skills found in current Market Access teams have been sourced from previously existing specialist areas in the brand life cycle. And much of the work done during those prior years has relevance in Market Access now.

We asked around the firm here and came up with a selection of perspectives and experiences based on our work in previous years.

Generic defence

Surely the wrong end of the life-cycle? Yes and no. Market Access projects often involve interactive graphical models to communicate price efficiency and efficacy for payer decision support.

These tools are similar to the work we were doing several years ago when a certain Oncology blockbuster anticancer brand went off-patent. 

In those days we used the sales force and mailshots with CDs to take financial models of hospital budgets based on cost of treatment out to the payers. Interactive graphical models for prescribing influencer decision support and advocacy tracking across advisory boards were common.

No more CDs for the sales force today though. Today we are fortunate to have tools like the iPad plus a much improved Internet.

Pricing & reimbursement

Clearly this area is relevant considering that one of the key levers in the access fulcrum is cost. It is only natural this part of Market Access should feel familiar to our people since they delivered both global & European pricing data warehouses and analytics for pharma over the years.

Competitor product price comparison. Price to patient. Cost of days of treatment. Patient-assumption derived differential dosing regime models. Many of these metrics used in previous projects now feel relevant in the Market Access area. Especially since we worked on the RSS financial reporting for the original Betaferon MAH over eight years back

Post-market monitoring

Electronic access schemes felt most familiar of all to us as the PASLU was born and debates on outcome guarantees and risk-shares began in forums the whole world web over.

Managing administrative overheads? Patient registration & assessment? Online electronic schemes? No surprise that the challenges of delivering the PAS felt like a road already travelled as we looked back at our work in named patient restricted access schemes.

We have ten years of developing and delivering restricted access schemes via the Internet. Supporting NHS consultants, doctors, nurses, and pharmacists. Linking labs and clinics across the web with real-time point of care monitoring devices. Many of the issues raised in the PAS debate were not new to us.

Pan-manufacturer schemes

The central non re-challenge schemes we have delivered are interesting. 

Why? Because these are collaborative pan-manufacturer & cross-product schemes.

Maybe there is mileage in the idea of a PAS which reduces administrative & training overheads by supporting multiple brands in a single or reduced set of homogeneous processes.

Commercial business

Finally another opportunity for re-use spotted by the Commercial Director at a client. Being experienced with payers, prices, and cost of goods, and having already implemented an electronic system which generates reimbursements based on closing the loop with sales data, he suggested that the PAS was not dissimilar to his commercial agreements albeit with

different terms.

Within weeks his commercial system was loading 'length of treatment' data from the scheme and auto-generating financial reimbursements to payers via the existing SAP integration. 

Clearly we aren’t the only ones who see the parallels between past projects and Market Access now. However there is much new work to be done in the area and plenty of opportunities.

For example, answers to the cost uncertainties in value-based-pricing for new innovations in medicine.

Large volume risk share schemes using centrally collected prescription data to register patients, assess criteria, and generate reimbursements.

Master data management for mapping payers and driving reimbursements. 

And adherence tracking using QR codes on packaging to collect data directly from patients for OGS compliance.

Regardless of how the Lansley reform arrives, the payer is a key player and Market Access is an all important team.

As for us we’re always keen to work in an area with so much opportunity for innovation.

By Nick Plank - Technical Director, C&C Group Holdings Ltd

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