Ralph Sutton and Berkeley Greenwood, Axon/Decideum: How to set a story straight

Comms professionals have a central role when a market access strategy is being developed.

In a rapidly changing environment, designing and executing a successful market access strategy is as much about understanding the needs of non-clinical stakeholders as it is about working with traditional medical audiences.

Companies must shape their market access strategies well before a product is brought to market. By planning early, they can align their market access strategies with their clinical programmes and launch plans.

Effective market access strategies are based on an understanding of the environment and its stakeholders. Knowing how they interact, setting priorities and tackling potential barriers to approval, reimbursement and uptake will determine the success of any product. Scenario planning can predict how different stakeholders will act. Examining the worst case and working backwards to predict and deal with vulnerabilities should ensure that the worst never happens.

Based on this, strategies can be shaped that will bring together a range of skills in the company, including clinical, health outcomes, pricing and reimbursement, marketing, sales, public affairs and comms.

In the analysis phase, a company is likely to identify many challenges and opportunities, but the strategy should focus on the areas that will have the most impact.

Companies need a clear, uncluttered and evidence-based story. The way the story is told, the evidence used to support it and the storyteller will vary depending on the circumstances and the audience. Consistency and simplicity are critical when stakeholders talk to one another and background noise is often at fever pitch.

The story must be relevant to its audience, compelling and credible - that is, evidence-based. So whether told through a health technology assessment submission, in the media or face-to-face, there a clear rationale as to why a drug or device should be used and who will benefit most.

Efficacy and safety are not enough, even if they provide differentiators from the competition. The broader socio-economic impact of the drug or procedure must be communicated. For instance, in mental health or inflammatory disorders, if a drug can help people stay in work or reduce the need for care, it has substantial economic benefits. The importance of this will only grow with the proposed value-based pricing system.

Any weaknesses in the story, too, must be tackled.

Once the story is defined, stakeholder engagement is central to an effective market access strategy. Opinion leaders and prescribers are always important, but without support from payers, prescribers and patients will struggle to have access to a treatment. Knowing what payers are looking for and providing it in ways that are useful to them is vital. Unless a drug or procedure helps address payer needs, commercial success will be elusive.

Patient advocacy is always key, but companies should consider engaging with other consumer organisations such as groups that represent the elderly or employers.

Market access is an ongoing process and it is rarely about a single decision. Multiple decisions are made by multiple stakeholders to recommend a drug or procedure. The impact of the strategy must be continuously evaluated, stakeholder engagement plans maintained and adjusted, and the story reviewed and refined.

The multi-disciplinary nature of market access remains important, but in shaping and communicating the story, comms must play a central role.

Views in brief

- How will the proposed changes to the NHS affect pharma marketing?

It may have different implications depending on the disease area and region you are in. GPs are still going to need guidance on which treatments to use on which patients. Marketing must work closely with cross-functional teams to understand who will shape this guidance.

- How would you fill a five-minute meeting with Andrew Lansley?

It is probably too late to convince him not to spend years bringing in another major restructuring of the NHS. The UK has the potential to be a world leader in science and innovation, but we need private industry to invest here.

Ralph Sutton is managing partner of Axon Communications. Berkeley Greenwood is MD of Decideum

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