Paradigms change when questions emerge that the old paradigm can no longer answer. Market access has become a buzz word, as
access to markets is as significant a hurdle to product uptake as registration itself. Initially a topic for pharmaceutical
companies concerned about sales volume, it now affects all aspects of healthcare. The current understanding of market access
will undergo a fundamental shift in perspective, away from a company-centered toward a patient-centric view of the problem.
This column identifies several forces that challenge the current understanding of market access and lobbies for a comprehensive
approach that aims to address the needs of all stakeholders, with a primary focus on what creates value for patients.
What killed market access?
There are four reasons why the current approach to market access is doomed to fail:
The term "market access" itself says a lot about the self-centered mindset, which is one of the reasons for the paradigm change.
Healthcare companies want access to markets, revenues, and profits, and market access aims to persuade those that control
access to let them in. But the market access framework often does not address the needs and goals of all the parties involved.
Market access looks at the world from the perspective of healthcare companies with the ultimate goal of gaining access to
markets for their products and most of their attention is focused on convincing a few payers of the value of their products.
Market access is considered a remedy to address the pricing pressures the healthcare industry is facing—a result of a marketing
model that basically ignored the fourth P every marketer learns about in business school: Price. As policy-makers and payers
search for ways to control cost without compromising care, the failure to communicate a convincing value proposition to these
stakeholders results in our being forced to compete on price. The increased use of tenders as a means of cost containment
should be interpreted as a failure to communicate the value of a medication.
Market access is based on a one-size-fits-all, product-driven marketing model. However, while patients have similar needs,
the healthcare systems they live in go about pursuing the same common goal—improving public health—differently. A one-size-fits-all
approach is not effective at addressing the different needs in each market, yet to manage market-by-market is not realistic.
A practical approach is to define market archetypes and address the needs of each archetype effectively while leveraging limited
Traditional marketers tend to focus on lagging metrics such as number of patients diagnosed and number of patients receiving
treatment (often illustrated as a waterfall chart), but they fail to understand and appreciate the patient and payer journey:
Why does the market look the way it does? What are the incentives and success metrics? Marketers need to focus on understanding
the why instead of the what.