In competitive therapeutic areas, like immunology and oncology, optimizing market share depends on creating a more structured, holistic market access story. By augmenting traditional market access datasets with real-world data from claims and labs, manufacturers can follow patients’ progression along the care continuum—and uncover new opportunities to improve access.
- Understanding how access functions in reality
There are often notable differences between what a payer, PBM, or provider intends to happen and what actually happens. In recent MMIT research for a competitive oncology indication, we found that a top PBM frequently provided reimbursement for a competitor drug rather than the drug listed as preferred on their formulary. Claims data revealed the disparity between intention and reality, which had a significant impact on the preferred drug’s market share.
- Uncovering hidden influences
By analyzing claims and coverage data in parallel, manufacturers can arrive at a deeper understanding of the patient journey—and determine how to intervene. For example, when a patient is moving from a first-line to a second-line therapy, what’s influencing this shift? Is the change patient-driven, a result of side effects? Or is it driven by physicians or payers? In an MMIT analysis of oncology categories, we found that a considerable percentage of therapy changes are influenced by payers.
- Tracking disease progression over time
Integrating lab data into the market access data mix introduces another dimension of the patient journey. From a patient access perspective, lab data can help manufacturers find relevant patients and monitor their disease progression. Given the cost of specialty therapies, locating even a handful of potential patients via lab data can provide a healthy ROI.
Integrating real-world lab and claims data with coverage and clinical pathways data reveals a new world of opportunity for manufacturers. With full visibility into how patients receive care, manufacturers can maximize the ratio of diagnosed patients to treated patients—and optimize access to their therapies.
Read the full article on BioPharma Dive . To see how combined coverage, claims, and lab data can inform your market access strategy, learn about MMIT’s Patient Access Analytics and Lab-Based RWE solutions.