Don’t Shortchange The Payer Perspective

Donna Kerney Correia, PhDMarket Research

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Launching a new pharmaceutical product is no small undertaking, with no shortage of questions or tasks to be completed. Decisions have to be made. Resources have to be secured. Plans have to be executed. Just one piece of that launch puzzle is the market access strategy. What will payers in your targeted market channels ‘do’ with the product in terms of formulary placement or coverage restrictions or medical policy criteria? Arguably, this is one of the most important questions to ask, as payer acceptance bears a heavy influence on achieving commercial success for your product.

Are your glasses too rosy?

As launch teams focus on the tasks at hand needed to get the product to market, they are entrenched in the messaging about their product’s value, its potential benefit to patients and its place in the market. They believe in the product and the idea that the market would think otherwise may not cross their minds. However, payers may (or may not) share those views. For example, payers may see the value, but have concerns about the impact of this new product on their budgets. They may not be convinced of its benefit for everyone, and need more specifics on the patient types most likely to be positively impacted from therapy. Additionally, payers may be looking for large rebates or significant price protection from a new entrant, while the company may not be prepared to offer those financial terms. The key is knowing where you stand in the payers’ minds. That information will help in identifying where you need to focus your payer (and overarching market access) strategy.

A successful payer strategy needs time to develop. The perfect planning window is 18 to 24 months before projected product approval. During that time, talking to payers is important.

Have you done enough (if any) payer research?

Companies often engage in market research activities with providers and patients for a variety of reasons. They assess interest or acceptance of a product, evaluate barriers to prescribing, or identify product preferences. All of that information can be, and is, used in a variety of ways, including the development of marketing and support materials for distribution once the product is in market. These efforts are designed to help increase product uptake. But what about the payers? If they put up roadblocks to product access, uptake in the market will be slowed. It is best to know that sooner rather than later.

Are you continually engaging with payers?

Although many companies do conduct market research with payers, this tends to be done in the early stages of product development. Results are often used to examine market potential or shape internal pricing conversations. While valuable, these insights might be outdated by the time the product is nearing FDA approval or ready for commercial launch. It is imperative that companies engage with payers throughout the planning and development process. The rapidly evolving nature of the industry and the launch of other therapies can change the landscape for your product or the focus of payers. For example, years ago payers weren’t so quick to implement blocks on new market entrants. Now it is commonplace, and the ability of a manufacturer to remove that block and open up access varies – knowing what, if anything, can be done is crucial for developing a payer strategy and setting expectations internally about the product’s early market success (or struggle). The importance of the payers cannot be understated.

Even if you’ve done earlier research, continuing the conversation with the right people in the payer community as you approach launch is worth considering. At best, you confirm your initial perceptions and can proceed with the strategy you had in mind. At worst, you find you misjudged the payer perspective and need to adjust accordingly. Like it or not, payers can (and do) impact the commercial success of pharmaceutical products. And whether or not you can address their concerns or reinforce their positive impressions – why not at least make sure you understand their positions?

After all, it doesn’t hurt to ask.

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

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