1. New Strategies in Pharmaceutical Market Access
Albert Wertheimer, PhD., MBA
Temple University
Philadelphia, Pennsylvania 19140, USA
HealthEcon and Policy Association
Ankara, Turkey
5 December 2014

2. Market Access Definition
Process pharma companies undertake to ensure that their medicines are made available as widely as possible; are reimbursed and listed on formularies

3. M.A. History
Important last 5-10 years due to high-tech and costly products reaching the market, while great pressure by payers to cut costs

4. Tradition health economic KOL Reimbursement and payer KOL
Market to clinical knowledgeable Opinion Leader (KOL) but recently to:
health economic KOL
Reimbursement and payer KOL

5. Market Access Customers
Commissioners
Aescribing Advisors
Heads of Med. Depts.
Dir. Of Publ. Health
NICE leads
Chief Pharmacists
Hosp. Business Mgrs.
Service Managers

6. Early 2000s
Movement to Cost: Benefit and Comparative Effectiveness Research

7. Comparative Clinical and Econ Value (CCEV)
Payers want to know:
What outcomes will be achieved for their pt population
What outcomes have already been achieved
What is the rationale for product’s price point
What product attributes justify a premium price

8. The Old Days Company reputation Field force personal relationships
Low prices

9. The Transition Period
Deals with Multiple Products and Reference Pricing Schemes

10. Today: Several Approaches
Value based, risk sharing
Cost per QALY
CER

11. Today and Tomorrow Pay for Value Focus on Most Benefitted Groups
Promote for those failing generics & combos

12. Expensive Drugs Cap Total Expenditures
Refund above agreed-upon sales level
Promote to specific segments
Offer post-marketing studies

13. Decline of Surrogates & Models
Actual QoL data on morbidity and mortality
Actual Outcomes for specific populations

14. Actual Outcomes
Availability of Electronic Health Records

15. Differentiate Markets
Local clinical trials
Local KOLs
Individual pricing
Germany wants pt. data
Make negotiated deals—France

16. Solvani Example
UK pays $9 billion for this hepatitis C drug, because they see “value”

17. Market Access Strategy
Demonstrate Value to Various Stakeholders
Set the product apart
Understand that market’s characteristics

18. Some Final Thoughts Price reduction for Longer contracts
Share R&D Expense with Payer
Share Education Expense

19. Thank you