Strategic Insights

October 2013

Key Trends in Market Access: Implications for the Pharmaceutical Industry

Report Authors
Neil Grubert, M.A.

Introduction:

Healthcare payers around the world face the “perfect storm” of unsustainable budget deficits, aging populations, growing demand for high-quality healthcare services, and burgeoning drug pipelines. To have any hope of controlling their pharmaceutical spending, payers need to find new ways to manage market access.

The use of value-based pricing (VBP)—setting drug prices based on willingness to pay or the perceived level of additional benefit—is increasingly common. The burden of meeting payers’ health technology assessment (HTA) requirements is set to increase steadily, as more and more countries adopt this practice. Many payers are also making use of external reference pricing—benchmarking the proposed price for a new drug against its price in comparator countries. Managed entry arrangements can offer a way to overcome barriers to market access at launch, but manufacturers need to understand how countries differ in their approaches to managed entry.

Questions Answered in This Report:

  *   Payers are increasingly adopting value-based pricing (VBP) as a way to focus their limited pharmaceutical budgets on drugs that meet genuine clinical needs, and to better reward manufacturers for developing such medicines. What are the key features of these systems, and how will they impact the industry?

  *   Europe, Canada, and Australia have long employed health technology assessment (HTA) as a key element in pricing and reimbursement decision making. Other countries, including many emerging markets, are now following suit. What demands will this greater use of HTA impose on drug manufacturers?

  *   The practice of external reference pricing is on the increase. The number of countries using this cost-containment method is growing, the number of comparator countries is expanding, and the frequency of price monitoring is increasing. How will these trends affect pharmaceutical companies’ commercialization strategies?

  *   Managed entry is a strategy that can both reduce the risks payers face in covering drugs at launch and expedite market access for manufacturers and patients. What are the most common methods of managed entry? How do countries differ in the approaches they favor? How can drug manufacturers respond to the growth of managed entry?

Scope:

Markets covered: Argentina, Australia, Belgium, Brazil, Canada, China, Colombia, Egypt, France, Germany, India, Italy, Japan, Mexico, Netherlands, Poland, Portugal, Romania, Russia, Saudi Arabia, South Africa, South Korea, Spain, Sweden, Switzerland, Turkey, United Kingdom.


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