Embedding Market Access in Today's Pharma Business Model

Mar 01, 2013

As private and government payers around the world grow more powerful, obtaining market access promptly, at an appropriate price, has become critical to company success. In the past, if a pharmaceutical product was safe and it worked, market access was usually assured. No longer. Market access today is far more challenging due to a confluence of factors: the need to contain rising costs, the proliferation of competing drugs in the same therapeutic areas, and reliance on evidence-based medicine (EBM) and health technology assessment (HTA) to drive payer decisions. In addition, growth of the generics segment and the advent of biosimilar drugs have given payers additional choices when deciding what products they will cover.

Incorporating the "voice" of market access is crucial to effective deployment of the company's most important and costly investments, including Phase III trials, M&A negotiation, and resourcing for product launches. Underestimating or misjudging payers' likely approaches to managing products can carry a price penalty reaching into the billions of dollars over a product's lifetime. In response, companies have pushed beyond standard P&R activities to embrace strategies and capabilities across a variety of functional disciplines, which together broadly represent market access.

Some of the notable advances in market access strategy over the past three to five years include sophisticated segmentation of market and payer types, new ways of engaging payers to better understand their needs, and innovative go-to-market models on the local level that bring market access together with sales and public affairs to address specific customer needs. In addition, the industry has established processes and approaches to ensuring market access input into R&D and business development efforts, as well as investing in real world data and analytics to help better define product value to payers.

Discussions we have held with 200-plus global and regional market access executives over the past 18 months confirmed that companies can better integrate market access perspectives into their global, regional, and country strategies by addressing organizational structure and processes as well as talent management—including both market access specialists and commercial leaders. However, several practical challenges that may be preventing companies from doing more on the talent and the organizational fronts have been uncovered.

These challenges include:

» Less than 10 percent of the top commercial officers and regional leaders in the 15 largest global pharmaceutical companies have spent any part of their career in a market access discipline. (Analysis covers the top commercial leaders at the top 15 pharmaceutical companies—measured by global revenues. Four to eight business unit leaders and/or regional presidents were identified at each company, depending on the organizational structures.)

» Market access leaders are often perceived as the bearers of bad news or the "naysayers." For example, defending a price point that does not match the perceived value of the asset by others in the organization, or becoming known for killing a deal.

» The vast majority of market access leaders are not integrated throughout the organization. Analysis indicates that 69 percent of them have spent on average 12 years of their careers in a market access function, out of a total average of 15 years of industry experience. (The top market access leaders at the top 25 pharmaceutical companies—measured by global revenues—were identified. We identified between one and four top leaders for each company depending upon their structure. Where there are business units, each global market access leader was included. This analysis does not include regional market access leaders—it only includes those with global responsibility.)

» Market access professionals and their teams are often not aligned with each other, as they are spread out geographically, work in different functions, and even report to different leaders, making it difficult to develop a united perspective on strategy or tactics.

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