By Howard Deutsch, Associate Principal, ZS Associates (Sponsored Content)
Oncology-market access doesn’t “just happen” anymore. As competition in the U.S. health-care market only continues to intensify, oncology-drug companies will need a good corporate strategy to ensure physician uptake and payer coverage of therapies. Having strong clinical data isn’t enough, especially as stakeholders grow ever more sophisticated, weigh more options—and have more leverage to demand data and deals for contracts, discounts and rebates.
Oncology-drug companies can’t wait until these new demands are right at their doorstep. They must start working today to ensure they have solid yet adaptable market access capabilities for tomorrow. Good market access can’t be achieved on the fly. It can’t be cookie-cutter or static.
Here are three core capabilities to begin building now.
1. The ability to engage with a range of stakeholders
At one time, oncology companies promoted their products mainly to oncologists. But now, oncologists are not the only (nor even always the primary) decision makers when it comes to treatment choices and the stakeholder ecosystem will continue to grow in complexity. So companies need to map out the stakeholders and develop a strategy to address all of these decisions makers effectively.
The stakeholder map will vary widely by geography: In Boston, for instance, hospital groups predominate; in Texas and Florida, broad oncology practices are more common.
Companies need a deep understanding of these stakeholders and a stakeholder-specific strategy for engaging each in the field. They also need the right personnel, in both number and skills. These personnel need to understand stakeholders’ motivations and engage with them—and sooner rather than later.
2. The ability to design contracting and discounting strategies
Although pharmaceutical giants may have extensive experience in contracting and discounting strategies for general medicine, they are often unlikely to know how to design and evaluate contracting and discounting strategies specific to oncology. And oncology-focused companies need to build new capabilities altogether. All companies need to understand the tradeoffs among oncology treatment options. For example, they need to understand where payer contracting is appropriate, how much to rebate payers and what terms to negotiate. Some of the contract structures that emerge may also differ from the predominant flat or share-based rebates that we have long observed in general medicines. Companies may need to explore innovative ideas like indication-specific contracts for oncology drugs that could be used for a variety of patient types, each with different competition.
Pharmaceutical companies also need to account for the fact that the data used for evaluating strategies is typically spottier in oncology than in other therapeutic areas, requiring them to use analytics and triangulation from multiple sources to arrive at the right levels of contracting and discounting.
3. The ability to operate contracting and discounting strategies
Once companies have a solid understanding of the stakeholder ecosystem and developed specific strategies, they need practical ways to make their contracting and discounting strategies work. Those with a legacy in general medicine have related experience in other therapeutic areas—but they need to adapt those abilities for the unique environment of oncology. And oncology-specific companies often need to build them from scratch.
At issue are tactical capabilities. Once contracts are signed, how will companies deliver on the terms? They will need to undertake several tasks—collecting data from payers, GPOs and other integrated providers; validating the information; paying rebates, and others—all at once, and carry them out seamlessly.
These three capabilities aren’t the only ones needed for successful market access, of course, but they do represent some of the fundamental, ongoing changes oncology-drug companies are facing.
What other capabilities are key to maintaining and strengthening market access—now and in the future?