What is market access in pharmaceutical industry?

What is Market Access?

Put simply, Market Access is about eligible patients having rapid, consistent and sustained access to medicines.

Without a coherent and well-planned market access strategy, the chances of a successful launch of a new product or service will be seriously hampered. In this article, Sandra Laird, Dice’s Director of Medical Education and Market Access, explains why, in the modern healthcare environment, Market Access is much more than HTA submissions and approvals.

Why Market Access is important – what is its purpose?

Market Access has become one of the most important disciplines in the pharma marketing mix, for the following reasons:

• Payers and prescribers are acutely aware of the increasing costs of healthcare provision, especially when considering advanced therapies which might not fall into ‘traditional’ categories
• HTA bodies are the custodians of cost effectiveness – no cost effectiveness equals no market access
• Local providers are more interested in cost than cost effectiveness, so local market access initiatives are vital

If you can help your customers get to grips with all of these issues, then your Market Access programme is working.

Increasing costs need to viewed through a ‘value’ lens

Positive NICE Guidance = job done?  Not by a long chalk! It’s the start of the journey, not the destination.

Just because your medicine has positive NICE (or SMC/AWMSG) guidance, it doesn’t necessarily mean that it will be adopted – and used – by individual clinicians. Sure, it will mean your product is included on formularies and ‘made available’ to prescribe, but it doesn’t mean that NHS organisations will position it favourably on their local pathway. It doesn’t mean that they will position it for the same patients as the NHS organisation in the next locality. Nor does it mean that individual clinicians will not advise patients that other treatment options are more suitable for X, Y and Z reasons.

We are a long way from top-down market access in the UK. Even in oncology, where NHSE is the commissioner, prescribing decisions are still made at a local level. To ensure rapid, consistent and sustained access it is still up to us, as marketeers, to develop the compelling arguments, to align with NHS priorities and demonstrate the value that our product brings.

Local market access tools are needed now even more than ever. How strong is your value proposition? Is it truly compelling?

Patient demand in context: the vital importance of a budget impact model

Should you develop a budget impact model? Even if your product doesn’t save money, the answer is yes, because it can help to reduce uncertainties. As the NHS struggles to balance the books, having certainty is more important than ever. Help to do this and you will support more rapid adoption.            

Where does your treatment fit into the pathway as a whole? Are there local, regional or society guidelines? Are your products included in them? If not, why not? What can you do to change this and drive increased consistency of prescribing? How can you support peer to peer exchange and increase access and consistency of prescribing in specialist centres vs. DGHs?

Accessibility: the ongoing need for clinical champions

Developing clinical champions will always be important. Without clinical demand for your product, you will not succeed. Without clinical demand no local commissioner will champion access.

No medicines manager is sitting in their office wondering how to maximise uptake of new products. The ‘system’ still responds to clinical demand. If no clinician is ‘champing at the bit’ to use a product, or building a case for a change in the pathway, it won’t happen. The exceptions to this will of course be if your product is substantially cheaper than its competitors, when clinicians will be the ones being asked to change.

Rapid, consistent and sustained access to new medicines needs a system wide approach. Companies need to understand how their product is commissioned and what impact it will have on current service provision. As pharmaceutical companies we think about products, our customers think about pathways and protocols and services. We need to start to adopt a systems-wide approach. Clinical champions remain key, but wider stakeholder engagement and an understanding of the broader decision-making unit is increasingly important, especially where a business case is needed.  

What does the perfect Market Access plan look like?

There is no such thing as a perfect market access plan. Successfully navigating NICE means having the right data, having clinical and patient organisation support and understanding and managing uncertainties. Achieve positive guidance and the NHS must acknowledge that your product is cost effective. 

Remember, cost effective is not the same as affordable in a cash-strapped NHS. It’s now up to you to build and communicate the value proposition, demonstrate the budget impact and demonstrate how your brand can be integrated into NHS services and the treatment pathway.     

What does the future of Market Access hold for the pharma industry?

The UK is now one of the lowest cost markets in Europe, with a PAS associated with virtually every new product launched. Add VPAS into the mix and many companies are starting to question the viability of launching in the UK. As an industry we need to engage in a dialogue to shape the future of access to new medicines in the UK and we need to take responsibility for generating the right data, not just the data the regulatory authorities want. There does however have to be a wider discussion about affordability and a grown-up conversation about affordability of healthcare in general. There are no easy answers and a collaborative approach will be needed.