Successful strategists know the battle is won or lost before it takes place – it’s won or lost in the strategy. Achieving successful market access, globally, demands company-wide understanding and appropriate resource allocation to achieve the right strategic imperatives.
One of our client’s challenges was to overturn a national tender away from a Top 5 competitor. The goal was to reframe the decision-making criteria to ensure full appreciation and reward for the brand. Tactics required systematic mapping of decision makers and influencers, clarification of decision-making criteria and the subsequent reshaping of these criteria, based on credible evidence. The battle was won before it was fought.
Strategic imperatives:
- Plan well ahead to understand fully, then shape the access decision-making criteria ahead of the access decision
- Shaping the environment takes time – no less than two years
- Invest in shaping the company first to deliver total alignment with, belief in and commitment to your value proposition.
Preparing a payer to say ‘yes’
Across the world payer customers want a clear, evidenced argument if they are to say ‘yes’. They want predictability of meaningful incremental health outcomes versus Standard of Care (SoC), plus certainty of budget impact. They can become positively passionate about a brand that delivers incremental value over SoC in areas of high unmet medical need.
Is it easy? Reasons for failure include lack of understanding of how to build phase II and III trials with the right patient populations and the right outcomes measures. In turn, this is a consequence of failure to develop a commercially viable brand vision linked to target patient segments. Only if this is addressed effectively in clinical development and HEOR, will the TPP be not just reimbursable but also funded from budgets at national, regional and local level.
Many primary care conditions are in areas where SoC is now a generic (Type 2 diabetes, asthma, hypertension). A premium price relative to a generic is now likely in the new world of value-based pricing; the reason a major company withdrew from the new AMNOG process in Germany in 2011.
Strategic imperatives:
- Think about price from a payer’s perspective, in terms of payment for incremental health outcomes, not selling a kilogram of powder
- Be bold and challenging in developing novel pricing which delivers better payer customer value
- Develop solutions in populations with high unmet medical need where SoC is not a generic.
Ensuring you get market access
Agreeing intellectually that market access is really important is just not enough. Action is needed, right now. To be successful, market access tools and processes must be embedded and fully integrated at global, regional and country level with: R&D decision gates in the clinical development process and brand planning and LCM. New product commercialisation and launch excellence planning for pipeline assets without market access integration are redundant processes. This implies that market access must be a company capability, not a department. Everyone needs to ‘do’ market access to succeed in today’s increasingly challenging economic environment.
Our broad experience with market access teams in US, Europe, Latin America and India demonstrates clearly that cross functional teams at global, regional and country level must have both the competence and the confidence to integrate comprehensive market access tools and processes into everything they do.
Strategic imperatives:
- Integrate market access tools and processes across all key development and commercial processes at every level
- Educate your teams – especially senior management
- Build market access capability across all functions.
Winning in market access requires realism about the environment, pragmatism in developing capability, culture and process and an intuitive eye for strategic imperatives that drive access. This approach enables increasing numbers of battles to be won before they are fought.
The Authors
Colin Wight is Chief Executive and Mark Boyden is Vice President, Business Development at GalbraithWight
They can be contacted at: c.wight@galbraithwight.com or m.boyden@galbraithwight.com