Editor’s Note: As the Biotech industry faces unprecedented levels of uncertainty in the midst of a trying macroeconomic environment, it’s more critical than ever for commercial stage innovators to deploy effective go-to-market strategies that generate sustainable brand growth. Sustainable growth strategies are those that maximize adoption (amongst patients & HCPs) while also protecting gross-to-net by avoiding free good overutilization. Such strategies can extend cash runways, provide a positive story for investors, and can even position biotechs for a successful acquisition
As life science companies continue to invest in and launch specialty and specialty-lite medications to help patients manage chronic - and sometimes debilitating or life threatening - conditions, they are tasked with developing patient support services programs to help patients access and stay on these therapies. Unfortunately, a poorly utilized program can undermine clinical efficacy and often hinders a brand’s commercial success. Despite pouring $5 billion each year into patient support programs, pharmaceutical manufacturers only get an estimated 3 percent of eligible patients to enroll and use their programs
Editor’s Note: With the lion’s share of R&D investment in the pharmaceutical industry flowing into specialty medications that command high list prices, insurers continue to search for new avenues to reign in prescription drug spending. Aside from enacting utilization requirements that often contribute to significant barriers to patient access, many payers are exploring value-based contracts with life sciences manufacturers that pay based on the positive health outcomes that therapies deliver for patients. The logic is that manufacturers should not pay for therapies that are not efficacious for an individual's health
Strong market access, the ability of a pharmaceutical manufacturer to secure reimbursement and coverage for their products from payers and other decision-makers, does not always translate to covered dispenses at the pharmacy level – particularly for specialty and specialty-lite therapies. Manufacturers must also navigate a complex prescription fulfillment and payer utilization management landscape to overcome barriers to patient access. Here are the three biggest reasons why good market access does not guarantee coverage and what commercialization teams can do to overcome this challenge
Editor’s Note: While there is a patient-centric intent to many prior authorization (PA) practices, they often create a significant operational burden for healthcare providers and disrupt the patient experience. Today, most branded medications witness low HCP PA submission rates which in turn result in high rates of prescription abandonment and manufacturer patient assistance overutilization. Both have negative consequences for pharmaceutical brands that are most commonly felt in the form of reduced brand loyalty and gross to net (GTN)
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