Hassan Chaudhury
Hassan Chaudhury

The PM Society Market Access Interest Group (MAIG) is made up of members from both industry and agency. The Group sent out a short, open survey in late 2016 with the objectives to determine how well Market Access is understood, what the barriers and opportunities were and if possible establish if there is broad uniformity or not in how Market Access is defined.

There were 104 responses (50% pharma, 41% agency with CRO and Medical Devices making up the remainder) but there was such variation in the make-up of the responders that we must caution that results are viewed as directional rather than definitive.

We had some genuinely interesting findings. For example, of those responders currently working in Market Access the average time at their companies was higher for responders from agency (12.4 years to 9.2 for pharma). This might suggest there is more experience of working in Market Access on the agency side.

However, when we asked people to score their own understanding of Market Access out of 10 we found respondents working in pharma rated their own understanding of Market Access higher than how the agency side ranked themselves (6.71 vs. 5.74).

Interestingly, pharma respondents also felt, on average, that their own understanding was slightly higher than the understanding of their own company (7.35 vs. 7) and this was reversed for the agency-side with these respondents ranking their companies higher than them themselves on average (5.74 vs. 6.04).

Importantly those who aren’t currently working in Market Access but would like to do so (around 11% of all respondents), scored their own understanding lowest of all (4.18 against an average overall of 6.26). This indicates that perhaps there is a genuine barrier for new talent to enter the Market Access arena. This finding is borne out by responses to how well companies support people in their roles. Those who aren’t currently working in Market Access but would like to do so scored the level of support they received from their companies lowest again (3.45 against an overall average of 7.27).

Perhaps the most interesting finding was in how there was hardly any uniformity in how respondents chose to define Market Access. We expected variation but the 93 responses to this question (11 responders to the survey missed this one out) had so much difference that we struggled to encapsulate it. The average response length was 23 words. The shortest was 3 only words, the longest was 87!

We analysed the responses for the most common phrases and, if we discount common words such as 'to', 'the', 'and', 'or', 'of' etc. as well as the words 'market' and 'access' we found the following top 10 (please note the numbers should be viewed as approximate as there are so many variations possible e.g. RIGHT/APPROPRIATE):

 

1.   MEDICINES/DRUGS/TREATMENT/MEDICATION/DEVICE/THERAPY/PRODUCT/PRODUCTS/PRODUCT'S/INVESTIGATIONS   91
2.   RIGHT/APPROPRIATE   54
3.   PATIENT/PATIENTS   46
4.   NHS/HEALTHCARE/HCPS/CLINICIANS/PAYERS   35
5.   ENSURE/ENSURING   27
6.   LOCAL/REGIONAL/NATIONAL/COUNTRY   25
7.   PRICE/PRICES   20
8.   VALUE/BENEFIT   20
9.   PROCESS/PROCESSES   19
10.   TIMELY/TIME/RAPID/SPEED/SPEEDY   17

 

 

Surprisingly some phrases had fewer mentions than expected out of the 93 responses. Partnering appeared only once in the responses. Choice was only mentioned twice, the same as with affordable/affordability. Uptake was only mentioned once and entry twice (although this may be due to respondents using the phrase 'access' instead). Pathways and data only three times each and evidence only twice. Reimbursement was mentioned six times, innovative only five and environment only nine. Respondents were also coy on the commercial aspect only mentioning it or related words three times (commercial, commercialise or commercialisation).

 

We wondered if we could use the 10 most frequent phrases used in the survey to come up with a definition with the same average length of response (just 23 words). Here's an attempt:

“Ensuring patients receive appropriate treatment at the right time and right price, working with the local/regional NHS and their processes based on value”.

The PM Society has already developed a definition of Market Access and it is instructive to compare them both:

“Principally market access involves preparing a positive environment which supports uptake of your product and demonstrating the ‘value’ of your product to the range of customers who influence uptake. Strategically, market access is about packaging data in the right way, for the right customer at the right time”.

It appears that that much of our old definition has been validated by this survey. However, the positive environment isn’t there, nor is uptake or data. What we found was a new emphasis on processes which may well be a response to how much change there is in the organisational structures and agendas of the NHS and how processes are sometimes all that we in Market Access can hang our hats on.

It appears as though the definition of Market Access is shifting as the environment changes and the fluid nature may well be useful.

While there was variation in how companies can improve their approaches to Market Access and the challenges we face it was not at the level of variation in the definitions of Market Access.

Finally, suggestions of how the Group can support Market Access professionals had a clear winner with education at 45%, and networking and celebration of excellence equal at 21% each.

Specific suggestions spanned areas far wider than we first envisaged and ranged from networking with Department of Health to how generic oral liquids fit into care pathways to the impact of Brexit. This suggests that the MAIG should clarify its purpose even further to ensure no misunderstandings.

Help to keep up with the pace of change in the NHS with speakers who can expound on the latest agendas. Over half the survey participants are willing to attend networking and educational events but agency respondents preferring events in London.