The pace of experimentation and reorganization of Market Access and Pricing functions will accelerate as HTA and coverage demands change, and regulator confidence in expanded evidence increases.
Real World Evidence is starting to reshape the organizational map in pharma, and is leading to a market wide reconfiguration of traditional Market Access functions. Market Access, in particular it’s Outcomes Research cohort, were already close compadres with their RWE cousins, and the trend to break out OR and embed it into a more cohesive post-launch research function with RWE is a trend we expect to see accelerate.
Market Access continues to bridge R&D and commercial, and has established itself as a useful ‘firewall’, but most organisations will align it more closely to either research or commercial leadership, leading to some movements in how the function is resourced and managed and leading to changing organizational and performance objectives. Narrowing of the Access platform has likely been a major underlying factor in the very non-uniform resourcing at Access functional groups, as it is difficult to establish an maintain a talent pool outside the organization which can be flexible enough. By this we mean the redistribution of traditional Market Access functions such as Outcomes Research to cohort with RWE primarily, but also ongoing experimentation with the core model – and we see this in the Global and Regional Access models, but also – more starkly – in experiments with BU, Agile and ‘Value Demonstration’ approaches where RWE and Access are integrated almost entirely.
Integrating Real World Evidence into Access at both global and local levels is increasing in importance. Coverage with evidence (and equivalent HTA recommendation) is already well established, and is placing further strain on Market Access functions; not least in integrating groups which are fundamentally at odds in methodology but united in objective, but also the technology investments required to undertake large scale RWE generation and synthesis when the Access function itself is in an experimental state of flux means cost attributions can be mired in internal politics.
So what then are the key capability drivers for Market Access functions in this shifting model?
Talent acquisition and retention remains the No 1 priority and challenge for Market Access functions globally. External support, from consultancy firms, is widely provided but fragmented as many Access consultancies tend to be boutique to small to mid-sized. High performers in Market Access in 2020 and beyond will be individuals with the agility and organizational intelligence to build effective collaborations across functional cohorts including Public Policy and RWE, but also will be fluent in the data agenda. Individuals able to identify the source and viability of insight rich patient data, with a view to RWE ‘production scale’ are operating in the new model of Access.
Model variability is giving rise to increased career mobility at senior levels.
Pricing, HTA submissions, Health Economics and Outcomes Research are (typically) aligned into commercial leadership. By moving Outcomes Research to a combined OR/RWE cohort, which is inherently R&D, the scope of Access is narrowed and the talent profile shifts. Where there was a single P&L and reporting line to conduct Access programmes, now cross-functional collaboration is essential. Given that most global Market Access leaders report into the Commercial organization, while OR/RWE reports into Medical/R&D, there are inevitable conflicts of interest around resourcing and budgeting. Understanding and navigating this environment provides opportunities to develop career paths into either pillar of the organization. In fact, to move beyond C+2 or C+3 level via Access, we typically see high performers consciously develop opportunities in both, to progress past the Global Access Head level.
The model is further enhanced by a trend to resource Access at a regional or even local level. This of course makes sense in markets where there are complex portfolios, particularly demanding HTA criteria (IQWiG would be an example, where opportunities to introduce RWE are very limited v e.g. the FDA and NICE, both of whom are leaning into the RWE agenda). Local knowledge can also be powerful in the run up to launch, and the more pipeline a company has in place, the more Access support locally is needed.
So where next?
Traditional Market Access will, of course, continue, though through proliferating models. The strategic gains look to be in integrating real-world evidence into earlier access planning (something which the major life sciences consulting firms have been pushing for some time), and developing RWE strategies which bring functional silos around one Access agenda.
Consulting Point sees a timeline in which Market Access teams will increasingly become the coordinating cohort of multi-disciplinary, data-rich insights production incorporating traditional and enhanced real-world data types. Enhanced in this context points to PRO data, and the potential to deploy Machine Learning and NLP to mine large texts and images, much-expanded Registries which go beyond safety data, and signals development where traditional biomarkers aren’t available so clinical data is sparse.
For one of the newest value creators in the pharma product cycle, Market Access has been – and will continue to be – the most unexpected laboratory.
Written by Kevin A’Court, Principal Consultant – Healthcare and Life Sciences.