Market access in healthcare is the ability to successfully translate knowledge and facts from medical science, economics and social situations into a complete value story. The big challenge is to first understand what value means to all key stakeholders:
Value for patients
Patients may question how a new medical product can meet their expectations compared to the alternatives in terms of life outcomes, such as quality of life (QoL) gained and survival benefits.
Value for doctors
Doctors may have different expectations than other stakeholders. Treatment choices are not always in line with scientific rationale or patient expectations, and a persistent therapeutic effect may not always be necessary. The value placed on a new technology can also be different from one doctor to another. In oncology, for example, the balance between efficacy and safety is often interpreted differently between physicians.
Value for payers and decision-makers
Before a drug or medical device becomes available to patients, health technology assessments are performed by the relevant authorities who ultimately decide if paying for the technology is warranted. This is a complex task as the payer is often conflicted in the decision-making process. Is reimbursing the drug or device worthwhile, or could the money be better spent given budget limitations? Should a reimbursed drug be withdrawn? In most cases, value for payers means value for money, and payers always value new medicines or technology with multiple criteria in mind: How big is the medical and social need for a new treatment? How severe is the given disease? What is the incremental benefit of the new technology and how much evidence is there to support it? What is the economic impact of the new technology?
Market access specialists therefore need to have a deep understanding of the entire context in which the new drug or technology will be applied and the value that it represents to key stakeholders. Clinical evidence and knowledge of real patient needs, including the impact of a disease and its treatment on caregivers, family and work, should form part of the overall assessment. Pharmaceutical or medical device companies can avoid uncertainty by creating trial designs that best reflect daily practice. The results of real-world evidence (RWE) can help to provide treating physicians with a holistic view of the benefits of the drug or technology so that they can embrace and support it. For payers, real-world outcomes research is gaining significant momentum given the uptake of managed entry agreements.
HCC and its partners understand that navigating healthcare systems is complex and not always straightforward as different stakeholders have different needs. By focusing on the key pillars of clinical research, health economics, market research and real-world outcomes research, HCC provides stakeholders with the knowledge and insight required to facilitate decision-making. As market access specialists, we work directly with patients, medical specialists, economists and the authorities to find common ground with one goal in mind – access to new technology for patients in need.