With payer coverage decisions around pharmaceuticals changing rapidly, simply being covered is no longer enough for getting patients on therapy quickly. Today, increasing market complexity and outsize payer influence have resulted in numerous hurdles to ensuring adequate access, from prior authorizations to step therapy to label restrictions.
To succeed at launch amid these higher stakes and ever-evolving market dynamics, pharma companies—especially those within the oncology or rare disease spaces—need a go-to-market strategy that tracks market access in real time.
Why timely action requires even timelier insights
Consider the first CAR-T therapies that entered the market in 2019. Despite the hype surrounding them, these brands remained well below blockbuster status during the first two years post-launch. Why? One factor is the lack of timely payer policy coverage data to inform go-to-market strategies.
It turns out that the high cost of administering these brands was forcing many payers to conduct slower reviews, and many imposed coverage barriers within their policies. If brand managers would’ve had an up-to-date, holistic picture of their market access outlook during launch, they could’ve made adjustments along the way by targeting the accounts that were dragging their heels and imposing restrictions.
Fortunately, the brands recovered and hit quarterly sales above $150 million. However, as this example makes clear, acting on timely insights to target payers and physicians during the first few months of launch can be the difference between three years of slow growth vs one year of explosive sales.
Building a real-time road map for success
For pharma companies looking to ensure adequate market access from the outset—to get therapies into the hands of patients much quicker—building a go-to-market strategy that sits on a foundation of timelier market access data is key. Here are two key components of a successful strategy:
- Weekly—not monthly—internal marketing access reporting: Oftentimes, changes in coverage happen on a weekly basis, yet pharma companies tend to pull access data once a month. That means that coverage changes could go unnoticed for weeks—a critical amount of time for engaging physicians with promotional messaging and outreach. What’s more, if a physician is unable to confirm coverage when they’re ready to prescribe, they will take the path of least resistance and prescribe a competitor product instead.
- Email alerts that are both timely and relevant: Receiving notifications on coverage changes for your brand (and your competitor’s brand) greatly reduces the time that sales reps spend combing through payer websites and coverage documents before calling on key accounts, allowing them to spend more time in the field hitting their access goals.However, while real-time alerts are handy, true success hinges on their relevancy: Salespeople need the ability to target their alerts to their key accounts and sales channels, and to filter out the “noise” of any irrelevant updates. The more relevant and action-oriented the alerts, the more successful the sales team.
While winning product launches are never one-size-fits-all, smart pharma companies are incorporating much timelier market access data as they go to market—and setting themselves up for both launch and long-term success.
To learn how MMIT can help you track the impact of weekly coverage changes for your brand, learn more about our Launch Coverage Analytics solution.
And for a deeper dive into how and why pharma companies should be incorporating timely market access data at launch, check out John’s recent Meet the Expert webinar, Tracking Access in Real-Time.