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Smart Thinking blog

Insights and expert advice on the key issues facing today’s pharma marketer

Market access and the importance of early stakeholder engagement

Join the webinar on December 10
market access webinar

There are two key elements in any successful strategy: knowing what to do, and knowing when to do it. Yet in terms of market access, there appears to be a lot of talk about the former, but not so much about the latter.

There is no doubt that the processes and capabilities that pharma organisations need to employ have evolved. Since the creation of the UK's clinical commissioning groups (CCGs), the early development and implementation of a holistic market access solution based on local clinical and payer insight has become even more crucial. This move towards localisation requires pharma companies to clearly develop their market access strategy, which means starting at a global or European level, then drilling down to the local. This in turn requires investment in the right capability mix with associated flexibility along the journey – something that biopharma can enjoy by partnering with organizations that have proven capability and a broad holistic market access solution mix. But it requires a new approach, and the transition may not necessarily be an easy one.

The impact of the economy

The need to optimize services and clinical pathways in radical new ways is further fuelled by the current economic focus – opinion leaders such as Nuffield Trust and NHS England believe that the current funding gap could grow to £30bn a year by 2021. With such a massive financial challenge facing the NHS, the pharmaceutical and medical device industry has a real opportunity to be part of the solution. But of course, this can only happen if companies challenge their own processes and operating models, both in the UK and abroad. Successful UK market access means considering a vertically integrated approach between Global/European organisations and UK affiliates.

This economic austerity has already triggered a change in approach by CCGs and NHS England. In the past, primary care trust managers, GPs and acute providers often disagreed on the optimal clinical pathway for patients. But now we are seeing a genuine move toward local clinical consensus around how services should be delivered and the place of therapy in the pathway. The problem is that pharmaceutical and medical device companies are often not part of these discussions, or engage far too late. So what is causing this disconnect?

Old habits are hard to break

In this austere climate biopharma has had to adapt to the new demands being placed on them. They know that NICE approval coupled with clinical enthusiasm for new treatments is no longer enough, and that in order to demonstrate real-world outcomes, they need to ensure healthcare professionals and providers use the product in the right patients at the right time in the right way, as part of a fully optimised pathway. While this might sound logical, it seems that the industry often leaves it to chance, or overlooks the opportunity to support the NHS in getting new innovative treatments to the right patients.

The problem often comes down to legacy ways of working, outdated processes and a global top-down approach to brand strategy development based on commercial aspiration, rather than bottom-up, based on NHS payer insight. In other words, biopharma knows it needs to change, but it doesn't always happen as quickly as the industry would like. However, the good news is that addressing these challenges is achievable. And the route to success means embracing different ways of working, to different timelines and questioning current commercial models.

Early engagement, early insight

When we say early, we recommend starting to engage with UK payers at least two years in advance of anticipated commercial launch. Linking a global brand strategy to the development of a tailored local market access value proposition is an important and challenging aspect of a UK organisation's focus, and will have a significant impact on the likelihood of brand success.

By talking to payers about their requirements far earlier on in the lifecycle of their product, companies can make sure that they address the difficult balance between doing everything that payers ask for (which could be impossibly expensive, slow and risky) and doing enough so that relevant data can be built into trial design, and relevant outcomes are captured during the development process.

Moreover, mobilising early insight shouldn't be restricted to data but should consider the wider patient pathway and different NHS models of care. Early mapping of the care pathway and underpinning funding mechanisms can shape understanding of what needs to happen and when. This holistic understanding will allow pharmaceutical companies to decide what support outside of the drug technology they are willing to provide – or indeed need to provide – to ensure robust patient outcomes are achieved. After all, if a company has an extremely cost effective drug but there is no way of getting it to the right patients – either because a suitable care pathway has not been agreed, or funding incentives in the current model of care means providers are unwilling to change – how likely is that product to be used?

Mobilising insight as soon as it's available

To avoid the 'approved – but no use' scenario, the solution is to optimise the care pathway before launch. In an ideal world, companies should be sitting down with the commissioners and provider teams well before launch. They should talk about the drug, its cost effectiveness and benefits as soon as meaningful data is available, and then demonstrate how it can impact outcomes as part of an optimized care pathway. Effective local engagement with NHS stakeholders by individuals with the right mix of capabilities, focused on pathway simulation modeling, change management, pathway re-design project management and ultimately real-world data capture are capabilities that pharma should deploy.

The idea is to capture local insight from commissioner and provider perspectives and drive consensus on how the drug should be used and what the pathway looks like. The insight generated from this local engagement could have the added benefit of helping shape the brand strategy and positioning of the drug on commercial launch. Companies could have the insight needed to wrap their drug into this wider solution and show how its value can be realised as part of the optimised pathway or service.

Have your say

Ultimately, it's about knowing when to begin developing a local value story, and engaging with payers at an earlier point, so you get a holistic understanding of the patient pathway. It's something I think is hugely important for UK market access, which is why I will be leading a webinar about exactly that on December 10, 2014 at 14:00 (GMT).

Get involved in the debate that will shape the future of market access for biopharma and book your place for the webinar.

Article by
Ryan Wooller

is director of market access and service innovation with responsibility for a number of Quintiles market access teams in the UK. In his role Ryan is responsible for working closely with BioPharma customers to support the development and execution of their market access strategies.

25th November 2014

From: Sales, Marketing

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