There is, at this time, a constant and continuous pressure to find the balancing point between patient access and budget management in the delivery of health care products. Novel interventions are faced with intense scrutiny by payers who need to balance expenditures against fixed health budgets. As such, market access becomes the pivotal element in balancing competing interests for drug manufacturers and reimbursement agencies.
For several years, emerging markets focus was on entry and partnership and building a business on mature products. Most recently, we witness additional efforts being invested into access to patients of branded medications to provide better disease management than generic products. Budgetary pressures are promoting ever closer dialogues between payers and providers to reach convergence towards mutually beneficial solutions. As such, more and more, premium pricing for new pharmaceutical interventions becomes increasingly scrutinized. In this climate, demonstrating the value of a new therapy, plays a large role in determining the pricing and reimbursement structure.
Negotiations around the benefit in order to substantiate the price of new and innovative drugs is a reality for every product’s launch. Often, these negotiations are continued after launch, with additional pressure on manufacturers to demonstrate in local markets the product price and value to payers. Market access depends on these negotiations to justify the products’ premium pricing through real-world evidence.
For instance, in the Middle-East, payers exhibit a predilection towards financial based risk agreements due to limited resources for monitoring and enforcing performance based agreements. At the same time, early access through temporary marketing authorization has been used successfully to gain early market penetration and avoid delays patients’ access to new treatments.
The rapid growth of merging markets paint a very attractive picture to the pharmaceutical industry. Their untapped potential promises access to large patient populations. Challenges still exist due to various barriers to new entrants. As such, strategic positioning is an ever increasing issue that needs to be address in a timely fashion.