Patient access to innovative medicine in Europe
A collaborative and value-based approach
In light of pressurised healthcare budgets, growth in personalised medicine and increasing requirements to demonstrate value, are current market access models sustainable? New research released by the Deloitte UK Centre for Health Solutions explores the current market access and pricing challenges presented by the European market, and provides recommendations on how pharma companies can work more collaboratively with payers to help patients gain access to the latest medical innovations.
Market access challenges facing payers and pharma
Fragmented payer systems
Each European country has its own health care system, with different backgrounds, population sizes and epidemiological factors, as well as different payer systems. These differences affect decisions on whether a product will be approved and at what price it will be reimbursed.
Demand for value
The burden of constrained health care budgets, an ageing population, increases in chronic diseases and increasing pressure from patients and pharma to fund products for rare diseases has increased significantly, putting pressure on European health care systems. As a high percentage of health care costs are fixed and difficult to tackle in the short term, governments have adopted a number of pricing strategies and policies to exert downward pressure on consumables.
Complexity of personalised therapies
Scientific advances have enabled a more personalised approach to prescribing, moving away from traditional volume based business models. Pharma has also shifted to developing biologic products that are able to treat difficult diseases such as cancer and autoimmune disorders better than traditional therapies, but are most costly to produce and therefore are often priced at a premium.
Differing requirements for evidence of efficacy
To increase patient access to pharma innovation, the European Medicines Agency (EMA) has implemented an accelerated approvals process for breakthrough medicinal products. However, the shorter length of trials have created challenges for payers and health technology assessment (HTA) authorities who prefer longer-term data to reduce uncertainty around a pharma product’s efficacy and cost impact.
Succeeding in the new market access and pricing environment
Approaches to market access and pricing therefore need to change with a variety of value-based contracting models emerging. These models require a more collaborative relationship between pharma, payers, providers, physicians and patients, in which all members work together. In particular, Pharma companies should:
- improve understanding of the scientific and economic considerations of both regulators and payers
- utilise early access schemes to gather evidence on a product’s safety and efficacy, and partner on services and technologies in order to develop solutions that clearly demonstrate value ‘beyond the pill’
- develop regulatory and technical standards and skills to ensure data privacy and interoperability, including registries that allow tracking of outcomes and multi-indication pricing.
Building market access competencies for the future
To ensure continued market access success, pharma should develop these core organisational capabilities.
Earlier launch planning focused on dialogue: to understand payer needs earlier in the R&D process including earlier dialogue with payers, providers, physicians and patients.
Innovative contracting: to design contracting and service solutions that meet the genuine needs of the system, payer and patient, and support its sustainability.
Real-world value dossier creation: using RWE to develop a true understanding of system challenges, physician and patient experiences and the benefits of your products and services.
Build trust and understanding: be a collaborative partner in your therapy areas by providing tools to improve medication adherence and develop stronger relationships with payers based on increased transparency.
Build the skills and expertise needed for the future: adopt new ways of working and recruit people with both deep technical skills combined with problem solving, advocacy and communication expertise.