Expert review: market access – a function or a state of mind?

Mark Waker

MTW Consultancy Ltd

Market access and its challenges have filled many column inches in recent years. Organisations like NICE have now been established for over 10 years and the NHS, although ever changing, has been set sail on a steady course to more formalised decision making on drug choices ever since Tony Blair’s white paper back in 1997. Despite all of this, many companies still struggle to ensure they can execute strong, efficient and effective market access strategies both in the UK and with their global functions.

Why is this?

We will take a look at market access in the context of the bigger commercial picture to search for some answers.

The fundamental question is “what is market access?” At a UK level, market access means ensuring that all the barriers to prescribing are removed, and any opportunities within the environment are maximised to ensure a rapid uptake of new drugs at an optimum price from launch. This may appear to be a simple definition, but its triviality is not reflected in the highly complex and challenging way in which this goal is achieved – and it rarely is.

On a broader level, market access is often referred to in the context of HTA submissions with health economic and health outcomes being a key focus. These are of course highly skilled and critical elements to achieving the outcome of market access but they are not in themselves “market access”. Market access requires the right decisions to be made long before a local affiliate starts to consider launch strategies in their local markets. It requires a strong value proposition, linked back to the core of the brand’s essence, which is meaningful and relevant to the multitude of stakeholders involved in health decision making. Finally the value proposition, whether that be in the form of an HTA or otherwise, requires the right people with the right skills and the best tools to execute this at the customer interface. From clinical trial design through to medical, regulatory, legal marketing and sales – almost everyone in an organisation is truly involved in market access.

“Market access requires the right decisions to be made long before a local affiliate starts to consider launch strategies in their local markets.”

Therefore, is the art to successful market access being a skilled conductor of the orchestra, ensuring all these disparate elements – not always comfortable in communicating with each other – are coordinated over a long time period and often across continents? Or – is market access really a function at all? Perhaps market access is merely an outcome and key to running a good commercially-minded organisation. In its purest form, market access is actually a mind-set.

Let’s take a look beyond the boundaries of pharmaceuticals to explore this further. As an industry we tend to be introspective and seek for definition and ways of doing things from within. But within FMCG companies and across the entire retail sector we can point to countless examples of innovation and success. There are innovative products with large R&amp,D budgets and long lead times launched to complex markets with multiple stakeholders. All within the framework of tight government regulation in a competitive and price-conscious world. These circumstances are not a million miles from the conditions in which the pharma industry trades.

Organisations like Gillette spend billions of dollars on their R&amp,D programmes, and to get from early research to the launch of a new razor blade could take years. Highly specialised scientists are employed to undertake pioneering research. In parallel, commercial people must predict market conditions several years hence and develop value propositions to ensure the new product is meeting unmet need which the consumer is willing to pay for at a price that will sustain further innovation investment. Does this sound too different from the workings of a pharma company?

“Market access is a subconscious mind-set belonging to everyone involved.”

Within the retail / FMCG world I have never heard the term market access. However, market access is exactly what they are doing from the moment an idea becomes a business proposition. Market access is a subconscious mind-set belonging to everyone involved. The fact that our industry actually requires a term to effectively describe what should be a core part of essential commercial business may be a damning indictment on the way our industry has gone about its work for the past 20 years.

Of course, the pharma industry does not operate in exactly the same environment as the retail sector but I believe that there are far more similarities than differences. So if market access is a mind-set and a sound way of doing business, why does our industry continue to struggle? We can’t simply put it down to regulations, the tight financial restrictions or the changes within the NHS. These are significant challenges but they are not unique to pharma, and are overcome far more readily in other industries.

Mind-set is very hard to change, both individually and collectively. However it can be done, and I believe what the UK and global pharma industry requires is new blood. The pharma industry needs to have the courage to stop recruiting in its own image. This is difficult when there are time constraints that require bringing people into organisations with the right contacts and who are already up to speed with the workings of the industry, as too often teams are recruited in a crisis. However, for long-term success I truly believe our industry would benefit hugely from the breadth and depth of skill seen in the retail sector and who can bring a fresh set of eyes to some old challenges.

Recruitment companies such as PIR Interims have certainly experienced a significant increase in requests from clients seeking interim support in the area of Market Access. Companies are specifically looking for European and International life science expertise and these candidates are scarce. When looking at candidates from outside the pharmaceutical industry PiR Interims are acutely aware that these candidates will currently be rejected out of hand by clients compared to those with a pharma industry background, this being true of many if not all functions within the sector.

“We can learn from our colleagues in other industry sectors and the pharma industry has far more in common with these industries than differences.”

Market access has been a struggle for too long. The industry has some excellent and highly skilled individuals in the areas of health economics, health outcomes, government affairs and technology appraisal management. However, market access needs to be released from this cage alone and spread virally across an entire company so that it becomes a mind-set and eventually just sensible commercial practice, whatever function you sit in. We can learn from our colleagues in other industry sectors and the pharma industry has far more in common with these industries than differences. Therefore bringing new skills and fresh blood into the industry from outside could be the key to success and integrating market access into the fabric of the business we do. True success in market access will come when we no longer refer to it by name.

Part 2 of the ‘Expert Review’ series on the ABPI code can be viewed here.

About the author:

This article was written by Mark Waker, Managing Director, MTW Consultancy Ltd commissioned by PiR Interims.

MTW consultancy Ltd is an independent consultancy offering integrated market access solutions to the pharmaceutical industry. If this article has stimulated further ideas that you wish to discuss please contact Mark Waker on 07976 416740 or at

PiR Interims is a leading provider of Interim Management Solutions to international life science organisations. They identify and place some of the most highly regarded professional interims in the life science sector. PiR Interims works across a range of functions including: Medical, Clinical Development, Regulatory Affairs, Project Management, Commercial, Market Access, Manufacturing, Quality Operations, Supply Chain, HR and Finance.

Email: Phone: +44 (0) 844 880 4340


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