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Managing and maintaining evidence

In today's market, effective value communication needs to be evidence-based
Red file

Market access success depends on the effective communication of clinical, health economic and humanistic evidence supporting a new intervention. However, the so-called 'fourth hurdle' can mistakenly be seen as a one-time event. Health technology assessment (HTA) bodies routinely review their own decisions, while local access can involve regular rationalisation of hospital formulary decisions. Meanwhile, interventions may acquire new or expanded indications based on new data, requiring fresh, informed decision-making by payers.

As a consequence, evidence needs to be actively managed and maintained over time, something that can represent a real challenge to market access teams.

Big is not always beautiful
In order to manage the wealth of information needed for market access activities, global strategic teams often prepare a product 'core value dossier'. Used to support reimbursement and HTA applications, these dossiers are usually large summary documents summarising the additional value a new intervention brings in terms of health and economic benefits. As market access specialists routinely communicate with payers across multiple therapy areas, these documents often contain detailed descriptions of the disease and current management, as well as clinical trial and patient-reported data supporting the product. These documents are also required to meet the needs of market access specialists located in the markets themselves, and hence often contain country-specific, as well as global, data.

As you can imagine, it is easy for these documents to become bloated and over-long, making navigation to key information difficult and tedious. Add to this the need for these documents to evolve and incorporate new data over time, and value dossiers can quickly become a millstone for market access teams.  

Go modular
There are several ways to address these issues. A modular approach to value communication can reap real dividends. Presented with leading key messages, modular summaries can allow users to access the information they need in bite-size chunks. If further detail is needed, structured abstracts of key supporting references, or even pdf copies of the articles, can be hyperlinked via the summary text or value message. This also ties value messages to the supporting evidence in a clear and transparent fashion, a real advantage for markets following the principles of evidence-based medicine.

A modular, layered communication can be achieved through traditional document formats. However, the real potential of this approach is released when hosted on a web or intranet platform, which can be a flexible, adaptable way of communicating centrally prepared value messages to a wider team.

Version aversion
Version control can be another headache for market access teams. Static documents or spreadsheets, for example economic models, can be prepared and circulated by email. However, when updates to the data informing these tools are required, managing who has what version can become a real issue. Again, central hosting of core materials can obfuscate the need for circular email attachments; your market access team should always know exactly where to find the latest supporting materials. In addition, intelligent tracking tools can allow a central team to observe the wider usage of the tools and actively manage version control.

In today's market, effective value communication requires use of relevant and up-to-date evidence. Active management of this evidence can be the key to maximising and maintaining market access success for your product.


Ruairi O'DonnellThe AuthorAbacus
Ruairi O'Donnell is head of medical communications, Abacus International
Email him at:

27th April 2011


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