Market Access is becoming more and more challenging. This is irrespective of drug classes and new technologies. Payers are applying the same scrutiny on orphan drugs as on drugs for primary care. This is driven by increased budget constraints in healthcare systems and the heterogeneity of reimbursement systems worldwide.
In addition, many pharmaceutical companies are moving into personalized medicine, gene therapy, and orphan and ultra-orphan conditions with the goal of developing profitable premium drugs. But achieving this objective will force payers to face even bigger challenges.
A new realm of challenges
Therefore, in pharmaceutical/biotech organizations, the preparation for successful market access will need to be more stringent and strategic. On one hand, market access is a cross-functional undertaking; on the other, several of the cross-functional partners, like medical and commercial, have goals and objectives that are not necessarily aligned with what a realistic market access scenario could be.
Market Access professionals are therefore challenged by these functions and due to the fact that in the vast majority of organizations Market Access reports to the Chief Commercial Officer, an independent view from a market access standpoint is difficult to achieve. And when it comes to pricing, the complexity of being able to make independent realistic decisions becomes even more challenging.
A need to shift paradigms
Due to incorrect pricing decisions driven by commercial and marketing, companies have been punished in terms of achieving best optimal access and reimbursement. So, to manage complexity, to allow for the most rational independent decision-making in terms of pricing, and to best manage launch sequencing and value proposition development, one might consider the establishment of a Chief (Market) Access Officer that is organizationally on the same reporting line as the Chief Commercial Officer.
This role would still allow for cross-functional collaboration, but also present equal “power” for decision-making. In addition, balance of power hones market decision-making, resulting in a refined strategy that adds value and also ensures access to patients, thus improving society in general.
Are you interested in learning more about our perspective on Market Access, as well as organizational setup? Contact Thomas Hasmann, VP Market Access Practice Lead.