What is Market Access?

Market Access is the functional area focused on ensuring that third party payers including governments and insurance companies are covering or paying for drugs so that patient can actually get them once a provider writes a prescription. It involves setting pricing for a drug, negotiation of contracts and utilization management, and payer marketing. Market Access is also the in-house expert on the payer landscape and may advise on commercial strategy including life cycle management and where to play in the market.

What is Payer Marketing or Value and Access (V&A)?

Payer Marketing (also commonly known as Value and Access) teams are tasked with creating the overall payer value proposition for a drug and keeping it updated over the lifecycle of the product and as market conditions change. They also support the Account Executive teams with creation and approval of materials for use with customers including value slide decks, informational pieces, etc. The V&A team also sets the strategy for market access in alignment with Brand team strategies.

What is Pricing?

Market Access conducts the market research to establish the optimal price to launch a new drug at and ultimately makes a final recommendation to executive leadership. Pricing teams continue to monitor the performance of the drug, the competitive landscape, and the strategy of the Brand over its lifecycle and may adjust the price as conditions change over time.

What is Contracting?

Contracting refers to the work around signing agreements with payers for coverage of a drug. Contracts may specify a number of terms around rebates of various types, utilization management criteria, the type of formulary coverage patients would get, etc. Contracting teams work on creating criteria for field-based accountant executives on what would be acceptable in terms of specific contracts with individual payers.

What is a Market Access Account Executive?

Account executives are the everyday contacts for payers. They may address questions for customers or triage them to those who can. They also present to customers about new products or with materials and information provided by the Value and Access team. They are the primary point of contact for specific negotiations as well. In many ways the account executives are similar to sales teams with the key difference being that their customers are payers instead of providers. Read more about account executives.