As part of the research into our recent white paper on market access (published with Capgemini Consulting) we saw that pharmaceutical industries today have to deal with two contradictory trends combining major health-economics constraints allied with stricter cost-containment requirements:
• The rise in healthcare costs due to a growing prevalence of chronic diseases, increasing population of the aging and higher prices of new therapies.
• The challenging pricing &, reimbursement environment, with increased incidences of reimbursement rejections by payers, and a growing usage of pricing and reimbursement tools like reference pricing, generic substitution and price controls to bring down healthcare costs.
This leads to a shift to cost-efficiency and value requirements, which may depend on the disease area. These contradictory trends are reinforced by changes we see in the market access stakeholders’ map:
• Payers have an increased influence on physicians’ prescriptions. They scrutinize drugs on the basis of health technology assessments (HTAs). This leads to strong requirements of cost-effectiveness in addition to safety, efficacy and manufacturing quality.
• Patients are increasingly bearing additional costs of high priced drugs through co-pays. Their demand has barely shifted from drugs to cures.
Consequently, this stakeholders’ fragmentation results in:
• A broadened range of market access stakeholders.
• Globalization and regionalization of market access processes.
Understanding the needs of these new key stakeholders, while adapting to a complex and evolving healthcare environment, are key challenges that the pharmaceutical companies have to overcome to ensure patients can access their medicines.
Here we summarize some of the key challenges, critical success factors and key changes / change management tools required for pharma to effectively tackle the issue of market access.
Key challenges in market access
1. Understanding the stakeholders’ map
Given market changes, the decision making landscape has become a complex process with multiple types of stakeholders with intertwined relationships. Pharmaceutical companies need to identify the key stakeholders and understand their needs and how they interact with each other.
Stakeholder mapping is thus key to helping pharmaceutical companies understand the complex decision making landscape.
2. Differentiating products to achieve market access
Strategically, market access is now about packaging data in the right way, for the right customer at the right time in the changing healthcare markets.
The changing markets have accelerated the emergence of a key group of stakeholders to whom the drug makers have to prove the following:
• Economic value of the product, by offering a lower cost product, demonstrating lower overall treatment costs and/or reduction in additional potential costs.
• Product innovation through head-to-head proof of superiority and through outcome studies.
• Value-add services. Pharmaceutical companies have to prove the product brings a real added-value in terms of services to the patients (e.g. the product helps patients access and stay on therapy) or answers unfulfilled needs of key stakeholders along the complete care delivery chain.
Given these new challenges, it becomes critical for a pharmaceutical company to plan ahead and start early in the product life cycle to achieve successful market access for its products.
"Strategically, market access is now about packaging data in the right way, for the right customer at the right time…"
Key success factors for market access
To ensure product differentiation, market access strategies have to be integrated at each phase of the product development process. Pharmaceutical companies must focus on early incorporation of evidence from clinical trials to be ready for regulatory and reimbursement approval on launch.
Significant measures are taken today to achieve evidence building all along the product life cycle:
• Novel mechanism of action. Building up evidence showing novel mechanism of action resulting in fewer adverse events and/or associated costs.
• Convenience. Building up evidence showing increased patient compliance and therefore lower overall treatment costs.
• Scientific uniqueness / evidence-based medicine.
? Demonstrating connection between scientific uniqueness and clinical / cost benefit or effectiveness against highly-visible, unmet needs.
? Innovation showing ability to improve independent quality measures’ performance data.
Apart from evidence building to prove they offer differentiated products with added-value services, pharmaceutical companies can use innovative strategies to deal with the increased importance of pharmaco-economics, such as:
• Risk sharing / discounted pricing
• Evidence building
• Patient lobbying campaign
Internal impact on pharmaceutical companies
To deal with these market access challenges, pharmaceutical companies have to build new competencies and foster a stakeholder centric culture. This will have an impact on companies right across the spectrum.
1. Impact on culture and skills: shift to a marketing orientation
Pharmaceutical companies need to plan a cultural shift to a marketing oriented model:
• Adoption of a “pharmaco-economic” mindset.
• Development of a culture of “team effort” with strong collaboration between transverse teams towards common objectives.
• Integration of market access into key account management approaches (e.g. engagement with the hospital drug evaluation committee).
• New product arguments which answer stakeholders’ needs and are consistently communicated internally (pharmaco-economic arguments proving efficiency and added-value of the drug).
2. Impact on the organization: shift to integrated stakeholder management
To ensure a stakeholder centric approach, pharmaceutical companies should promote integrated stakeholder management which must become part of the company’s culture:
• Through the implementation of a dedicated department for market access or a field based team dedicated to relationship management for health economic institutions, as market access must be the focus of everyone in the organization.
• By breaking silos and optimizing internal collaboration, interactions and consistency of actions between the involved teams:
? Cross–functional team and collaboration across the corporate and country level.
? Optimization of market access initiatives allocation.
? Account management and coordination around market access stakeholders.
3. Impact on data: shift to a multichannel stakeholder view
Pharmaceutical companies need to rely on detailed and up-to-date data on the different stakeholders while being able to activate them and make the most of them according to their strategies towards a specific group of stakeholders.
4. Impact on tools: shift to a 360° customer view
Given the complex stakeholders’ map, pharmaceutical companies face the increasing need for an integrated tool containing information from all stakeholder-facing functions.
Supporting change management in a complex healthcare environment
Change is driven through the adoption of new processes and skills. However, the right data and tools can support companies in the integration of market access into the key account management approach. The knowledge of the stakeholders’ network and responsibilities can be supported by a specific data model and tools to support the assessment of key long lasting relationships.
"…the right data and tools can support companies in the integration of market access into the key account management approach."
The pharmaceutical industry requires anticipation of changes in healthcare systems and identification of needed capabilities to be fostered through training on topics such as business skills, networking and public relation capabilities, government background, pharmaco-economic knowledge and scientific and medical knowledge. On top of new capabilities, strong data analysis competencies are key to ensuring a high quality database and meaningful data analysis.
This results in a need for:
• Up-to-date market access data collected and shared through all channels.
• A comprehensive view of market access stakeholders, which helps pharmaceutical companies identify and manage different types of influence networks (e.g. influence networks based on price or on the efficacy of the drug).
Therefore, the pharmaceutical industry needs comprehensive and accurate databases, including different levels of influence and mapping of stakeholders’ networks by country, which is easily accessible through a flexible CRM system to allow for optimized key account management.
The combination of data intelligence within a CRM system can foster the effectiveness of cross functional collaboration towards market access activities, including critical activities such as strategy planning, objectives assessment, task allocation and measurement. The system should allow visibility into prospect and customer accounts for optimized relationship management with the key stakeholders involved in the market access.
In line with this, pharmaceutical companies have expressed interest* in the following capabilities for such tools:
• Ergonomic user interface, as the home office and the field based team are both involved in market access activities
• Centralized information (collection of external / critical company information)
• Capability to visualize a global/local mapping of key stakeholders in market access (complex environment)
• Capability to segment stakeholders in the data structure
• Capability to analyze information by type of influence
• Support of new capabilities within market access activities by delivering the right information to the right contact (process, role, decision-making level)
• Capability to visualize team within the company involved in the negotiations
• Capability to plan and monitor the relevant market access strategies
Market access is challenging all aspects of the way pharmaceutical companies do business. In addition to innovative approaches and operational structures aligned with the right internal skill sets, the development and implementation of suitable support tools is critical for success in this new environment.
* Source: Market Access Advisory Meeting, 30 Sept 2009
About the author:
Arnault Billy is OneKey Solutions Director at Cegedim Dendrite. For questions regarding this article he may be emailed at email@example.com. To download the full white paper or see more details on how OneKey can support market access initiatives please visit Market Access powered by OneKey.
About Cegedim Dendrite
Only Cegedim Dendrite combines the deep industry expertise and unsurpassed enabling technologies that help life science companies improve their bottom-line performance in the business-critical areas of sales, marketing, compliance and data. For more information please visit www.cegedimdendrite.com.
What tools are required by pharma to tackle market access?