Engage Early and Often.

In our last post (https://lnkd.in/gbJnvQdR), we spoke about the critical importance of Payer engagement. A question we often hear from clients on that topic is, “When should that process start?” The answer may surprise you. We believe that companies should engage with Payers as early as Phase II clinical development. Why? Because Payer’s want to thoroughly understand the value story and likely impacts to their respective budgets well before a medicine’s commercial launch. 

With budgets under mounting pressure, Payers are becoming ever more aggressive in managing costs by limiting access to new medicines through a variety of mechanisms such as new market blocks, restricted coverage policies, step therapy and high out of pocket costs for patients. The growing prevalence of these tactics is undeniable with traditional classes of medicines. Unfortunately, it is also becoming a more common practice for “protected” areas such as oncology and rare disease.

But all is not lost. There are actions manufacturers can take to minimize and overcome these risks through early and deliberate action.

• Engage Payers when designing clinical trials to identify and utilize endpoints and data that will resonate.
• Establish a value proposition that will justify the benefits and costs to them.
• Create communication materials that leverage FDAMA 114 regulations and allow you to articulate the economic benefits associated with adopting your new medicine such as cost-effectiveness and budget impact models.
• Activate key opinion leaders to advocate on your behalf and that of patients.
• Engage pharmacy AND medical leadership when communicating the comprehensive value of therapy.
• Determine if value-based contracts and/or warranties are appropriate and can be used to overcome objections to the price and value of your new medicine.
• Prepare sales teams to push through access barriers (e.g., prior authorizations, step therapy, and pricing objections) and pull through formulary opportunities (e.g., parity/preferred status)

Need help thinking through your Payer engagement strategy and execution timing to accelerate market adoption? Contact us at info@a3access.com.