Market Access and Reimbursement

Demonstrating Product Value to Meet Payer Demands

Market Access and Reimbursement


This comprehensive report examines market access strategy, objectives and trends with data from 70+ pharma and device companies across a range of different markets. Metrics from these organizations detail market access staffing, spending, timelines and activities. Deeper findings discuss how teams build a case for — and communicate — product value to relevant payers (including the development of convincing product value dossiers). Analyze timelines and best practices for integrating input from market access teams into product development decision making.

  • Description
  • Additional information


Market Access and Reimbursement: Demonstrating Product Value to Meet Payer Demands

  • Publication Date: August 2013
  • Pages: 250
  • Chapters: 5
  • Metrics: 500+
  • Charts/Graphics: 183

Encompassing five chapters, deep data benchmarks and analysis zero in on these key areas:

  •  Market access group structure and reporting relationships
  •  Budget trends and projections from 2011–2014
  •  Market access involvement/activity in product development
  •  Product dossier preparation and other factors influencing product reimbursement
  • Industry insiders’ ratings of, and solutions for, critical operational and market challenges

Data split by market:

  • US (32 companies)
  • EU/Can/Aus (32 companies)
  •  Emerging Markets (14 companies)

Data also split by:

  •  Top 10 (22)
  •  Top 50 (16)
  •  Small Pharma (23)
  • Medical Device (17)
Report Features

Though some companies’ market access budgets dipped slightly in 2012, the general trend of increasing budgets continued through 2013. Allocate budgets more effectively to key market access subfunctions throughout product development. Track market access budget trends and projections from 2011 to 2014. he timing and level of involvement of health economics and outcomes teams, as well as the government affairs function, can be the key to securing reimbursement for pharmaceutical products. Coordinate various market access groups’ involvement at the most opportune times during product development — and ensure a smooth launch. Know when and how often to assess your market access strategy — and establish a schedule to do so.

Reason To Buy

Whether companies have dedicated market access teams or address the function on an ad hoc basis, market access teams are most often led by directors or higher positions. Discover how companies with and without dedicated market access teams meet reimbursement requirements and support diverse portfolios. Build market access teams to grow alongside developing products to ensure efficiency and adequate resources throughout development and launch.

Target Audience

Life science company executives, directors, and managers involved in the following areas should consider purchasing this report:
– Market access
– Managed markets
– Pricing and reimbursement
– Government affairs
– Health economics
– Outcomes research
– Comparative effectiveness research
– Medical affairs
– Product managers
– Brand managers
– Strategic planning/management

Chapter Example

With such a wide variety of needs, many market access executives have difficulty finding employees who hold any combination of the skills and talents required for the job. Companies should work to attract the talent necessary for a complete team to help market access make the largest possible impact upon company strategy. A highly skilled, efficient market access group allows clinical trials to meet the endpoints that payers want to see, as well as makes sure account managers can best negotiate a better price with the payers. These payers are mainly government entities and insurance companies, but also include hospital systems with their own formularies. The role of market access teams ranges this widely because, even if public and private insurance plans agree to reimburse the product, hospitals need to have it on their own fomulary in order for the product to be accessible.

However, securing adequate resources to build a well-rounded team is a necessity for the success of market access groups. On the whole, market access budgets are steadily increasing, giving the teams more of the flexibility they need to achieve reimbursement for products. Market access budgets are also being allocated efficiently according to current trends in regulations and payer requirements. Health economics and outcomes research (HEOR), for example, has begun to receive a higher portion of the budget than before. This increase in resources follows the trend of government payers beginning to consider and implement requirements for HEOR data upon product launch.