Asembia's AXS26 Summit: Q&A with Kim Plesnarski

In a conversation with Pharmaceutical Executive at Asembia’s AXS26 Summit, Kim Plesnarski, vice president, strategic market access and patient support, Syneos Health^®, discusses how rapid digital innovation, evolving market structures, and shifting regulatory pressures are reshaping market access and patient support strategies.

Plesnarski explores the growing role of personalized digital communications, wearables, and integration into HCP workflows and EMRs in improving patient access and experience. Plesnarski also explains how vertical integration has added organizational complexity rather than simplifying market access, pushing manufacturers to act more like longitudinal healthcare partners. Finally, she examines how policies such as most favored nation rules and the Inflation Reduction Act (IRA) are forcing companies to rethink early portfolio planning and launch strategies, while new technologies, especially two-way communication tools, chatbots, and data-driven outreach, are driving meaningful gains in patient adherence and persistency.

A transcript of her conversation with Pharmaceutical Executive can be found below.

Pharmaceutical Executive: How is digital innovation transforming programs for patient access?
Kim Plesnarski: We're in a revolution right now. There is a strong desire to use digital communications that are personalized. So that's going to continue to grow, and I think as you look at what's coming next, there's new wearables that send information back to the HCP and to the program. So think about digital sensors, there's pills that can be taken that send an alert that the pill has been taken, there are medical wearables that you can see the activity levels that somebody is taking when they exercise. This all is information that can be used to create a better experience, better coaching, better education.

You need to be thinking about that now versus later, and I would say you need to be thinking about getting in the HCP workflow and EMR. This is where your HCPs are working, this is where patients are receiving communication. If this is an afterthought in your strategy, you're missing the mark at launch. You really can't be coming in later and saying, how do we enter here? How do we make it easy for patients to access our programs? And how are we using the data to create a better experience?

PE: How is vertical integration impacting market access strategies?
Plesnarski: It's making it more complicated. In theory, you would say vertical integration should make it easier, reduce costs, reduce friction. What I'm seeing is there's just within the same organization, silos and friction that they create within their own organization. So, if you're a market access professional, vertical has not made it easier.

You still need to approach the same problems and I think the newest thing that you have to address (some are doing it with hit specialists, some are doing it with their cams, some are doing with reimbursement), is making sure you're meeting with these large institutions, getting in the EMR, getting in the workflow, and helping them and helping their patients from diagnosis through end of treatment, and that's new, so you're feeling more like a healthcare partner versus these point solutions that existed in the past.

PE: Are regulatory policies such as MFN and the IRA impacting early-stage portfolio planning?
Plesnarski: Yes, it has made market access even more important to the gross go-to market strategy. You now have to ask the question, where am I launching, and has that impacted U.S, market launch pricing strategy and profitability?

In the past, you can say, where am I going to launch to maximize volume, that's an easier question to answer. So, Most Favored Nation introduces complexity there, and with the IRA, you have a shift in the market. There is a penalty for small molecule they only enjoy seven years before they must start negotiating on price, versus a biologic that has 11 years. So, companies have to ask, do I want to play here? And if I do, how do I accelerate getting into growth phase? Otherwise, the return on investment may not be there, and I think that hurts patients. It hurts the market, and it's just forcing everybody to be more precise, more thoughtful, and make sure they're launching with a very smart strategy to capitalize early and not destroy gross to net or price.

PE: How are new technologies impacting patient adherence?
Plesnarski: We're seeing a rise in two-way communication. They're seeing programs having a 20% improvement in persistency by having secure two way. Some of that is going to be with chat bot for very simple 24/7 support, which is important in today's market, but the other part is giving access to patients, to clinical educators and patient navigators that can provide that supplemental coaching and support.

So to me, it feels like it's old news. It's not. It's getting better. It's now 24/7 whereas before it might have been just eight to five. The second piece is the wearables. How are we harvesting data? How are we using it for a better experience to improve outcomes? I would say the third piece is using the predictive approach and reaching patients, not by having them sign up for another app, but reaching them right in a text message, getting them a secure portal and getting the support they need right there in that moment when it's likely occurring, versus constant reminders that don't really serve the patient and can be annoying do.