Internal Capabilities

Alignment of internal stakeholders:

The first step in achieving Market Access launch excellence internally is fostering alignment amongst all cross-functional stakeholders. The alignment of internal stakeholders is critical to ensuring Market Access success as, in many cases, a launch failure can be due to the misalignment of internal teams. A few factors to consider when preparing the organization for a launch include:

Ensuring a consistent definition of “Market Access success” across stakeholders

  • This should include developing accurate access assumptions to ensure there are no surprises once the product is on market. Access assumptions differ by therapeutic area and client, some clients have stated 50% of covered lives with unrestricted access at 12 months post-launch would be treated as a success while others state 60-75% of covered lives with restricted access at 12 months post-launch is successful. With potentially many cross-functional team members (including those who may have come from other organizations), clearly stating what success looks like in the launch phase ensures both accountability and a collective drive for team success.

Early involvement in New Product Planning

  • Numerous Market Access leaders have indicated that ensuring Market Access team participation in New Product Planning (NPP) is key for a product’s launch to be perceived as successful. Forecasting and embedding accurate access assumptions has become more of an art than a scientific method. Successful NPP teams ensure accurate forecasting assumptions are based on early Market Access landscape assessments and continue to refine these assumptions as they near a product’s launch. Our recommendation to clients is to include your Market Access partners in these early assessments. This will ensure forecasts for products are both fully vetted and accurate when a product reaches the market.

Objective and comprehensive understanding of Market Access environment:

Commercial teams also need to have a clear and comprehensive understanding of the Market Access environment when planning a launch. While this may seem obvious, many Market Access leaders have lamented the fact that actual access gained post-launch did not align to pre-launch forecasts. Pre-launch forecasts, typically informed by landscape assessments and market research, tend to overstate the value of a product within a payer’s mind. A key driver in the disparity of access gained vs expectations is that payers assess a product’s place in line of therapy at the expected net price, which tends to differ from where companies believe their product should be placed. Typically, companies believe their products should be used earlier in a line of treatment, which is then compounded by the higher net price offered to payers and leads to difficult negotiations. This is particularly true of in-licensed compounds, for which a Business Development team without sufficient access experience is responsible for assessing market potential. As they prepare for launch, Commercial teams need to explore the potential issues causing a lack of Market Access relative to internal expectations of a launch product value.

Understand and prepare for the evolving complexity of stakeholder engagement:

  • The final internal capability Market Access leaders need to prepare for is engaging with an evolving complex stakeholder group. The list of stakeholders that Market Access teams may interact with has greatly expanded with the rise of Integrated Delivery Networks (IDNs), Long-term Care sites, and retail/specialty pharmacy customers. With this expanded customer group, teams need to identify what the opportunity is for each customer and educate their field teams appropriately, so they are all aligned when speaking to a disparate set of customers.

Timing is important as well. Pre-approval Information Exchange (PIE) meetings provide opportunities to educate payers on clinical programs, target patients and health economics of the disease and its treatment, and identify where there are unmet needs that the client plans to address. These PIE discussions can begin prior to approval. When engaging with payors, Market Access teams should attempt to become a “co-creator” of value with payers rather than pursue each payer in a transactional fashion. This can be done through “above-brand” discussions with payers to identify issues/opportunities that matter to both parties, creating an edge over other manufacturers that are purely seeking financial gains via transactional engagements. Payers have indicated that the companies most successful in gaining access are manufacturers that conduct tailored engagement: providing the right information to the right stakeholder, at the right time. A few best practices to ensure your organization is ready internally for a successful Market Access launch include:

  • Create an internal governance structure to facilitate communication of key learnings across business unit teams and leadership
  • Closely monitor launch activity progress to course-correct early in the launch cycle and mitigate issues
  • Collaborate between Market Access and new product planning teams prior to finalization of Phase III trial design to identify outcomes of interest to payers for inclusion in clinical trials