While it is important to get drugs to market, it is equally important to understand the steps they take to get to the patient. Even after approval, they still have to go through several steps before they can be used by the patient. This is called the access journey. It is the series of steps pharmaceutical companies take to ensure their drug is accessible to the patient. It is called a funnel because the number of patients gradually decreases with each step. Even if the drug is approved for the entire population, the number of people using it is still less.
Access journey: A multi-step funnel
Just because a drug is approved for widespread use doesn’t mean it will actually be used widely. Pricing, payer decision-making and patient behavior all limit the use of drugs that are otherwise approved for the masses.
The process journey encompasses vital components such as pricing, payer access, clinical guidelines, provider formularies, prescribing and dispensing, and patient adherence. Every stage constitutes a crucial decision phase in pharmaceutical market access. If, for instance, payers restrict access or if physicians do not see enough value, the drug may not get to the patients.
Why each step matters?
Different decision-makers influence each stage of the access journey. Insurance companies are concerned with cost-effectiveness and long-term outcomes, providers care about performance metrics and operational efficiency and finally, physicians evaluate the clinical benefit.
Patients, in contrast, consider affordability, convenience and perceived effectiveness. Pharmaceutical companies must prove value to every stakeholder, not just the regulatory authority, since they have different viewpoints.
Designing a value strategy
Firms must not only establish robust approval requirements but also create a strong value strategy with the help of healthcare analytics consulting, to succeed in the access journey. This entails outlining in detail how a medicine provides different benefits and making sure these benefits are evidence-supported.
Understanding benefit domains
A comprehensive value strategy assesses a drug in multiple benefit areas, such as
- The advantages of clinical efficacy, safety and outcome
- Benefits at a humanistic level, quality of life and patient experience.
- Cost-effectiveness and economic benefits.
- Organizational advantages, influence on the functioning of the healthcare system.
Benefits to overall public health and communities.
These benefits are prioritized variously by different stakeholders. Doctors, for example, might be concerned with clinical outcomes, while payers are more focused on economics and longer-term value.
Aligning evidence with stakeholder needs
The right evidence is crucial when designing a value strategy. Regulators may accept short-term clinical data, but payers usually want long-term outcomes and comparator studies. Providers may seek real-world evidence that demonstrates improvement of performance metrics and patients may seek noticeable improvement in their condition.
So, it is important to align research and development with commercial needs from the outset. The way these trials are designed, endpoints and patient populations can impact how the drug is perceived along the access journey.
Breakthrough vs. incremental innovation
Value strategy also depends on the type of innovation. Breakthrough drugs that address unmet needs can command higher prices and broader access. The competitive standard requires incremental innovations to prove their value through improvements in safety, convenience and adherence.
The access journey and value strategy exist as two elements that share a strong connection. The access journey defines the route which patients take, while the value strategy controls the effectiveness of a drug as it progresses through that route. Pharmaceutical companies can achieve their goal of patient access through their long-term success by meeting stakeholder needs, building strong proof and showing their value.
