Market Access – Role or Goal?

Welcome to the MAIG Blog series! This is the first blog post on behalf of the Market Access Interest Group (MAIG) at the PM Society. The MAIG seeks to inform both market access (MA) as well as non-MA professionals around key topics and ensure all are engaged and up to date. It is ultimately a forum to support best practice stimulating creative thinking on how our work in this space can be more impactful.  We look forward to sparking great debate, discussion and energy around one of the most fascinating areas in our industry (OK, so we’re a little biased..)

MAIG co-chairs, Brenda Dooley, AXIS Consulting and Esther Nzenza, Decisive Consulting who have written this blog along with committee members David Alderson, Cogentia and Carwyn Jones, PM Soc have collectively more years in the pharmaceutical industry and indeed in market access than any would admit to having ! Today’s blog has been written to make the relaunch of the MAIG and for this first of many posts, we thought an interview format between Brenda & Esther would help to get us thinking about MA in organisations …

 

Brenda, shall we start with putting Market Access in context? What does it really mean?

That’s the key question isn’t it Esther and one that’s asked many times across organisations looking  to bring new medicines and health technologies to market. In the simplest of terms Market Access is just about getting important new treatments to patients when they are needed and at an affordable cost. We are asking in this our 1^st blog whether Market Access is a Role or more of a Goal for companies…in reality I think it’s a mix of both and not one or the other…we see Market Access now often a dedicated role in many organisations and pharmaceutical companies while it is also the ultimate goal of each individual with the words “Market Access” in their title.

Have we got that right though? Is it enough for an organisation to appoint someone to a dedicated role in “Market Access “and feel that box is now ticked and the commitment made ?… are we then ultimately saying Market Access is really just one individuals responsibility in a company so perhaps then it’s fair to call it role with a specific goal !  I think however that Market Access needs to go a whole lot deeper within company structures than it currently does…indeed I would go as far as to say that Market Access should be at the absolute core of every organisation who has declared that their mission to improve the lives of patients through making innovative therapies available … Only if Market Access is really sitting at the core of an organisation can its importance be fully realised and then the whole efforts of the organisation, and not just the individual, who has the title “ Market Access”, are brought to bear collectively to make new and important medicines available at the time they are most needed by patients.

 

Esther, is there really any difference between Market Access and Patient Access or are they actually the same thing?

Well that’s a great question. In part I think the terms are used quite interchangeably in our industry, one feeling rather more “patient centric” than the other which conjures up a very business-based metric for a very human type of problem. The core objective for both terms is essentially the same – making sure that great innovations (whether pharmaceutical, MedTech, med device or diagnostic) can reach the people for whom they were intended. In reality the role of the Access leader (avoiding either term here!) is essentially to make sure that all stakeholders are aligned in providing a treatment to patients without impediment. Hopefully achieved at a price that can be regarded as legitimate and fair by the system, and in a way that ensures the broadest range of eligible patients can benefit.

 

So who “does” Market Access?

Arguably Market (or patient) access is an outcome rather than a singular “thing”. It’s the composite of a medicine or treatment being approved, being successfully appraised through HTA, being priced in a way that’s judged to be fair and appropriate relative to alternatives, and then offered to the right group (s) of patients. That pathway doesn’t begin of course at the point of regulatory approval – it’s ideally a mindset that should run alongside new treatments right from proof of concept. Factoring into evidence plans and pathways the endpoints, metrics and proof that will allow patient and system benefits to be meaningfully characterised and communicated – and engaging the widest range of stakeholders. When approached this way it’s a mindset that transcends a single function and involves everyone involved in developing and commercialising a new treatment. I think of Access as one of the true unifying goals within companies – and to your point earlier Brenda it’s one where all specialist functions play a role. In practice of course you need conductors for this mighty orchestra, and that’s where the dedicated role/department/specialism is so important.  Having people focused utterly on the reimbursability (which may be a made-up word!) and ultimately patient access is central to modern day success in our space.

 

Brenda are you aware of any formal training course available for Market Access?

I wish there was a course or degree that taught all the core elements required for those working together on Market Access! However, in my experience its very much an acquired skillset although those with a marketing background often have a natural flair for the work itself. Maybe that’s down to the fundamental of marketing which is about really understanding what the customer wants . in Market Access the customers are many but can broadly be categorised into 3 P’s – the Patient who is to receive and hopefully benefit from the new treatment, The Prescriber who will need to prescribe where they currently don’t have a good / useful alternative and of course the Payers who will be funding the new treatment and need to be sure it will represent value for money.

I think there is a huge amount of learnings that can quite easily be gained from proactively reaching out and engaging with specialists in the area – the MAIG is one such group where people can come along to events, seminars and masterclasses and also just follow various discussion threads online to hear about what constitutes best practice in Market Access. Of course there are other groups too who have a more specific focus on economic analyses and HTA’s but for getting a really good working knowledge of Market Access and what you need to be doing to play your part in your company then you cannot beat just talking to people who have been doing it a while !!!

 

Esther – what’s the correct amount of resourcing/ investment in MA an organisation should consider?

A truly million (or more) dollar question! In essence, if you don’t secure access, all of the R&D brilliance, and all the most fabulous commercial plans will count for very little. I’ve seen companies start to shift their incentive structures and corporate goals towards measures of access for exactly this reason. It’s a bigger topic than we can cover in this blog but definitely a great discussion point for one of our future meetings. Many companies get to thinking about Access later than they should – which ironically only increases the resourcing need as teams then scrabble to weave together the right evidence and analysis. Early investment, earlier engagement and capability/competence development (and investments) throughout Product Teams from really early stages is what will move the needle. Not only money and people, but true focus.

 

How should Access teams be structured within companies? What have you seen work well Brenda?

Over the past 20+ years while supporting client companies on reimbursement applications I’ve seen some really fantastic examples where Market Access has operated brilliantly while also perhaps where it could have worked better…  not necessarily rocket science I know Esther but where I have seen it work well is in companies that have really coordinated their team to ensure it represented all facets of Access including Medical, Regulatory, Government Affairs, Marketing , Commercial including the General Manager and of course Market Access . We had one recent example with a client and at each and every call with our team at AXIS, we have full attendance from the company’s Market Access team ..that often meant we had 12 people from the organisation joining the progress calls but you know what ..it just worked so well and largely because the communication channels were kept wide open and everyone knew exactly what was happening and more critically what help they could bring at various stages…

Our MAIG meeting on Monday, December 12^th which is free for all to attend will tease out some of the points we’ve been making in this blog- if this sounds of interest and you want to gear more then please register by emailing Jenny at jenny@pmsociety.org.uk this week to secure your spot !