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All things Pharma

Market Access in practice: do you have a strategy?

This article is a little old… but if you’re interested in Market Access we have plenty of new content:

July 2018 Market Access Special Edition Magazine

Two way street: Industry/patient dialogue and its role in market access

Everybody’s talking about market access. But far fewer appear able to define it. In the competitive world of pharmaceutical sales, developing a market access call strategy can pay dividends. But do you know what that means? WG Consulting’s Simon Dawson and Elliot Rosen report.

Throw the phrase ‘market access’ into any discussion you’re having on the challenges of promoting pharmaceuticals to the NHS, and it’s likely that the person you’re talking to will give you a knowing nod that confirms a shared, mutual intelligence. After all, it’s quite simple: if you’re not thinking about market access these days, you’re nowhere. In fact, that prolonged yet knowing silence is quite possibly disguising an inward truth: your colleague knows that market access is extremely important, but, equally, they may not completely understand what it is and how to go about doing it . In the much-vaunted ‘new NHS’, having a market access call strategy is an imperative. The questions remain: what is it and have you got one? It’s widely agreed that a rigid reliance upon the traditional approach to pharmaceutical sales and marketing is a short-cut to product failure. Why? The market isn’t changing: it’s already changed and there’s no turning back. In the past decade, the environment for the pricing and reimbursement of pharmaceuticals has become increasingly challenging. Regulation in these areas has tightened and across Europe a fourth hurdle – cost-effectiveness – has supplemented the established notions of safety, efficacy and manufacturing quality as a further requirement to secure market access. This shift has accelerated the emergence of a key group of influential stakeholders and provided the catalyst for an environment that is increasingly being controlled by payers. Achieving market access in the modern market is as much about understanding the needs of non-clinical stakeholders as it is about influencing the traditional, clinical decision-maker. But, critically, a broadbrush approach will not work. Developing an effective market access strategy requires a more customised and agile approach.

What is market access?

For the benefit of those that nod in silent agreement at the mere mention of market access, some simple definitions of the term would be helpful. There are four basic elements. Essentially, market access is about:
• considering the implications your product may have on the wider healthcare market
• understanding the impact the changing healthcare market will have on your product
• preparing a positive healthcare environment which supports uptake of your product
• communicating the ‘value’ of your product to the range of customers who influence uptake.

Strategically, market access is about packaging data in the right way, for the right customer at the right time. In a changing NHS, aligning your product with a moving target is challenging and only by understanding the needs of all stakeholders involved in the adoption, positioning and funding of your product will you be able to develop messages that improve its chances of success.

Market Access Customers

So who exactly are these new key stakeholders, and can they be defined as ‘market access customers’? Broadly speaking, these customers can be collectively termed as ‘payers’ e.g. national and local decision-makers, policy makers and budget-holders. Their emergence has challenged the industry’s stereotypical KOL mindset – historically, a typical KOL has always been a clinical KOL – but now, the rising influence of health economic, reimbursement and payer KOLs is forcing companies to redefine their sales and marketing operations. “These are very much different to pharma’s traditional clinical customer-base,” says Elliot Rosen, Management Consultant at market access specialists WG Consulting. “Whilst they are not significant in terms of their ability to prescribe a product, they will, however, be making decisions about how the services that use these products are delivered. Some may be responsible for the development or implementation of national/local guidance, and others will be directly responsible for ensuring local funding for new and existing drugs. There is no point in trying to persuade a clinician to prescribe your product if you are not able to persuade the people who hold the purse strings and have the ability to change a service or create the opportunity for your product to be used”.

Market Access Customers

• Commissioners
• Prescribing Advisors
• Head of Medicines Management
• Director of Public Health
• NICE Implementation Leads
• Chief Pharmacists
• Hospital Business Managers
• Service Managers

More disease-specific market access customers also exist, most notably in oncology. These may include:

• Cancer Network Director
• Cancer Network Pharmacist
• Tumour Site Specific Leads

“In recognition of their growing significance, pharmaceutical companies across the industry now deploy specialist market access field teams to engage directly with payers” says Elliot. “The approach, however, can vary across companies and some have adopted a more account management approach that incorporates sales and market access in one role.”

Whichever strategy is adopted, the most important thing is to ensure that the huge amount of resource being invested in the field force is being converted into valuable interactions with every customer, and every customer group. But engaging with payers in the field requires a completely different approach to more traditional industry methodology. So how do you do it? One answer is to develop a Market Access Call Strategy.

Market Access Call Strategy

Field-based market access is about being able to understand the changing NHS environment and its impact on your customer-base, and being able to adapt your contact or call strategy in response to it. “Companies need to keep on top of change, identify who the key influences are, understand their needs and respond accordingly,” says Simon Dawson, Management Consultant at WG Consulting.

“Building a call strategy is about comprehending what is ostensibly a complicated matrix. It is vital that you understand the different spheres of influence around the customers you are going to be interacting with, and, critically, the best order in which to approach those different customers to maximise those spheres of influence. Having established the best order, you also need to develop specific messages tailored to those customers, so that eventually you have a very unified understanding of your product across all the key people who are going to be making decisions as to whether to fund or use the drug you are promoting.”

“Market access is about packaging data in the right way, for the right customer at the right time”

A market access call strategy should be developed collaboratively, with sales and marketing departments working in tandem. The strategy itself will need to be dynamic enough to be able to respond to market evolution, but sufficiently planned to accommodate all known interactions. This requires an aligned approach whereby the field teams capture the challenges faced in the field and work with marketing, either to understand the materials that exist, or to develop new materials that close information gaps in the marketplace. This all needs to be drawn together into a cohesive strategy that can be understood by the field force and ultimately used to drive product uptake.

The general principle is that there is no one-size-fits-all solution. The challenges you face in your market will change according to your product, therapy area and the setting in which your treatment will be used. Only by understanding where your product fits into the wider NHS can you customise the approaches that will work best. This requires the capture, sharing and interpretation of market intelligence from the field, with garnering information being the responsibility of the market access field force.

“First of all, you need to fully understand your environment,” says Simon. “Map it. Know who your customers are and what their needs are. Talk to them, engage with them and try to build a full understanding of their sphere of influence, how they are involved with certain processes and systems and how they are going to influence prescribing. Only then should you start getting out your materials, to engage with them even more effectively.”

Market challenges

Although the various barriers to market entry will vary from product to product, a number of common general challenges exist. These challenges, which will be indicated through field-based research, will require detailed and customised responses and will drive your market access call strategy. Here are some example scenarios that commonly need addressing and will inform a market access approach:

Typical field-based market access challenges

Trying to secure funding for a drug that has a negative NICE

Trying to secure funding for a drug that is awaiting review by NICE

Ensuring the effective local implementation of NICE guidance

Ensuring the NHS has sufficient service and/or financial plans in place to support the managed entry of new drugs into the NHS

Lack of clinical demand impacting on the level of funding secured

Scenario planning is a vital aspect of market access call strategy and will play a pivotal part in determining the order in which you engage with the various customers you need to approach. “For example, in one scenario you may primarily need to interact with clinicians to achieve clinical buy-in. Following this you may need to interact with a hospital business manager to understand the impact that using your drug in a hospital will have on a Trust’s income flow. From that point, once you have got the right messages communicated to those two customer groups, you may need to go to a Cancer Network level or PCT level, with the value messages for your product almost being presented by the customers you have already engaged with. This will build a positive wave of understanding amongst your customers, and will demonstrate how understanding the various spheres of influence can work to your advantage,” says Simon.

The simple guide to a Market Access Call Strategy

1. Start by mapping and understanding the local environment – what local processes are in place? Who is involved? What is their sphere of influence? Who are the decision makers, key influencers and implementers?

2. Understand their local priorities – what are their key challenges? What are their main objectives? What information do they need/like and when?

3. Tailor your messages to the needs of the customer base – different customers will need a different approach

Despite widespread endorsement of the principles of market access in the modern market, the example above does demonstrate that whilst payers are now widely acknowledged as being highly significant and influential customers for pharma, the traditional prescriber still plays a major role in product uptake. “It is important to note the need for clinical buy-in to drive the need for market access customers to address,” says Simon.

Achieving brand success in the modern NHS requires a thorough understanding of your marketplace; the key stakeholders and influencers, their needs and objectives, knowledge of funding flows and how they work in your disease area and advanced understanding of the likely scenarios and barriers you may encounter when trying to take your product to market. To succeed, you will need a market access call strategy.

Simon Dawson and Elliot Rosen are Management Consultants at WG Consulting. WG provides a range of bespoke services to improve market access opportunities for pharmaceutical companies in the UK. For further details, please contact simond@wg-group.com

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