A viable, well-executed market access strategy for a new pharmaceutical launch is crucial for commercial success. The interests of many stakeholders – providers, patients, caregivers, payers, manufacturers – must be addressed to help ensure the product reaches the right patient at the right time. If the ultimate goal of the strategy is to encourage product utilization, then it’s imperative that your strategy be:
This means identifying the impacted groups (e.g., patients, payers, your organization, etc.) and understanding what matters to them. It’s about realizing that barriers to access and utilization of your product can come from different sources and figuring out how to address those potential hurdles proactively. The list can sometimes seem endless. Tactics, programs, and systems need to be set up, financed, monitored, and measured to evaluate their impact.
Market access strategy is not only about the payers – though some may suggest it starts with payers who wield a great deal of power in the system. The payer piece is only one component of the overall approach for access. Think of it this way – even if every payer put your product on formulary with no restrictions, without education to providers about the availability and benefits of the medication or to patients about the importance of seeking treatment and the use of the product as an option, the ‘access’ granted by payers won’t matter much for gaining utilization. Similarly, even if everyone believed in the value of your product, if the financial burden is too high, utilization may be hampered. Potential provisions for financial assistance for patients might need to be explored; and if warranted, programs developed to offer such support as part of the strategy.
So much of the conversation around market access tends to focus on payers – and to some extent rightfully so. But we’ve acknowledged that there are other groups whose interests need to be considered (and balanced) as part of the strategy. Those interests are not always aligned and are often conflicting. For example, rebating and contracting efforts to gain access for your product in the market via the formularies at health plans and PBMs need to be balanced with the corporate financial goals of your own organization.
Balance is needed not only in terms of the acknowledgment of multiple groups but also in terms of the tactics used as part of the strategy. For example, patient education about the product may be beneficial, but the development of a DTC campaign needs to be balanced with pull-through initiatives to keep patients engaged, and ultimately on product if they are appropriate for treatment. An education campaign with no plan for follow-up is an unbalanced effort.
Your strategy should be clear and strong. But it must also be flexible. Use data to help guide what is working and what isn’t. As anyone who knows this space can attest, the times are always changing. And while it is important to have a core strategy, be sure to set expectations that the environment may change. For example, the corporate strategy at the outset might be small rebates. However, you may not be able to secure the coverage you want without larger numbers. It may be several months, or a year, and an adjustment to your original plan may be warranted. Adaptability is necessary.
As you develop the overall market access strategy for your product, keep it comprehensive, balanced and adaptable. Recognize that it is about formulary coverage, patient support, advertising, pull-through, provider support, financial assistance, reimbursement and contracting arrangements, etc. Such acknowledgment won’t guarantee commercial success, but without it, chances of commercial struggle (or even failure) are much higher.
Viking Healthcare Solutions has established itself as the premier provider of corporate account services and strategic planning support for the pharmaceutical and biotech industries. VHS Insights, our research division, specializing in payer profiling, market research and analytics, can help you find answers to inform your payer strategy. We support traditional and rare/specialty products to create, maintain, defend, and protect access to your product throughout its lifecycle. Bank on our experience to help you achieve successful product commercialization. Contact us at www.vikinghcs.com/connect.