Market access expert Caroline Ayres helps to de-mystify market access and its importance within global medical communications strategy.

It won’t have escaped your attention that the world is getting more complex… and nowhere is this truer than in the communications industry.

The backdrop to the rise of market access as a discipline is a sharpening focus on communications strategies that include both the payers’ and the traditional clinical decision makers’ perspectives. Although this may be something of a novelty in some markets, those with international experience have witnessed its evolution over a long time.

Caroline Ayres has been closely involved in the development of market access for more than two decades. As the first ever Health Economics Manager for AstraZeneca Australia, she spearheaded pricing and reimbursement negotiations, and, later, evolved global market access strategies for several leading brands.

Caroline’s recent arrival at Prime Global brings world class expertise to the team in this area. To mark her joining, Caroline kindly agreed to participate in a fascinating Q&A about her background, and about market access in general. We call it “demystifying market access”.

Full text of the Q&A follows.

CAROLINE AYRES Q&A

Demystifying market access

What is market access?

In the past, market access simply meant achieving reimbursement following regulatory approval. Over time, market access has developed into a term for the process of ensuring that appropriate patients obtain access to a drug (or device) product at an acceptable price. Market access success requires deep customer insights, building clinical and HEOR evidence to support the value of the product and then communicating key value messages in a compelling way. Gaining and maintaining market access therefore goes beyond the milestone of marketing authorisation.

How did it come about and why is it of increasing importance?

The need to demonstrate that a product provides value for money is based on the principles of health economics and arose from the need to manage escalating drug budgets. Understanding that resources are finite requires healthcare funding decisions to be consistent with the concept of obtaining the best possible outcomes within a given budget pot.

Those who manage such budgets (payers) therefore look at clinical effectiveness and associated costs of the new product compared with the best alternative treatments available. As well as the cost-effectiveness ratio, there is also a need to look at the impact on budgets and resources used. Payers want predictability on health outcomes and certainty about budget impact so are very keen to understand what patient numbers are likely to be eligible for treatment. These approaches are necessary to ensure that funding allocation is fair and transparent.

How did you find yourself specialising in market access?

I laugh when people refer to market access as a new thing! My career has tracked alongside the evolution of market access from the 1990s when cost effectiveness criteria were introduced in Australia for PBS listing and then in the UK for NHS funding. My qualifications are in pharmacy and public health and I have had a range of roles in the pharmaceutical industry. I became the first health economics manager for AstraZeneca Australia, which later included pricing negotiation with the PBAC and PBPA. I moved to the Global Pricing & Market Access function in the UK as a strategist supporting several launched brands and developing pricing strategy and value demonstration plans for early phase products. More recently, I have carried these experiences into market access consultancy, working with many different therapy areas across all stages of drug development.

What are the pitfalls of ignoring market access during planning?

To exclude the payer perspective and their evidence needs from brand plans will likely result in market access delay. Without a strong value proposition, payers will not be convinced about the need to fund a new drug and this will generally mean that the treatment is not affordable for patients to use and clinicians will not prescribe. Without market access the potential benefits of new drugs are denied to patients, carers, the healthcare system and society.

If there is just one thing for readers to remember, what would it be?

HEOR and market access is a critical element of brand strategy and should be integrated with all other launch plans (e.g. clinical, regulatory, commercial, communications, publications, public affairs) so that the payer evidence is generated and the value messages can be used consistently when communicating with external stakeholders.