THE DATA PARADOX –
Market Access Learnings
& Opportunities

Water water everywhere, but not a drop to drink.

– Samuel Taylor Coleridge

A Changing Landscape Redefines “Access”

While data is abundant, answering fundamental business questions is more difficult than ever. This is a direct result of the newest generation of biopharma products and their complex market access ecosystems.

​

We are experiencing a significant shift away from traditional retail products with pull-through focused on simple variables such as formulary tiers. New drug approvals are now increasingly dominated by specialty products, including injections and infusions with medical and/or pharmacy benefit coverage options. These drugs often involve complex distribution and administration requirements, such as specialty pharmacy mandates, site-of-care restrictions and white-bagging policies. Furthermore, simply understanding each of these access elements is not enough. They all interact, and in combination can significantly impact competitive positioning, office logistics and patient affordability. There is increasingly no “one-size fits all” market access pathway.
 

In response to this evolving market, data providers have expanded offerings to keep pace. Between external vendors, manufacturer hubs, and account teams, almost all key access elements are obtainable with sufficient budgets and resources. Ideally manufacturers should then have real-time access to holistic, integrated access data, with the ability to extract and analyze to drive business decisions.

But how many marketers actually have this type of system available? Surprisingly very few.

 

Uncovering Data Deficiencies

So where exactly do things break down? The most common issues faced by manufacturers today include:

​​

• Disconnected Datasets: Most marketers have access to standardized reports from their organization’s analytics teams and data partners that provide high value information (e.g., coverage and restrictions, claims, co-payments, sales). However, each dataset is typically delivered in predetermined intervals using set formats in a separate, disconnected file. The end result is fragmented data, viewable side by side but neither integrated nor flexible enough to realize its full potential as a decision support tool.
  
  These silos and proprietary data structures make it extremely difficult to effectively bridge access datasets and build a truly comprehensive picture of the access landscape that drives successful prescribing. Emerging evidence also indicates that the recent transition to a more remote workforce may result in further information silos and a decrease in real-time collaboration between teams.[1] This is a problem that demands immediate attention.
   

• Challenges Capturing Human Intelligence: Moving beyond syndicated data, organizational knowledge represents one of the most valuable assets of a biopharma manufacturer. The insight that account management teams have into payer coverage decisions, policies, and promotional guidelines through contracting and access to top executives simply can’t be duplicated by third parties.
  
  Although enormously important in creating accurate and compliant pull-through resources, many manufacturers understandably struggle with systematically capturing and applying this human intelligence to create value. Despite representing important intellectual property, this information often remains with an individual, and can be lost or diluted when that individual moves on to a new role. Even companies committed to collecting this information generally do so using inefficient and imprecise manual processes that rely on shared spreadsheets and email communications. This requires a surprisingly large time commitment, and distracts highly skilled and compensated personnel from their higher impact strategic activities.
   

• Data Reliability and Validation: Even the best third-party market access datasets are viewed by users with a degree of healthy skepticism. Collecting complex coverage and policy data from a massive web of Payers, PBMs, and Health Systems requires many different approaches, and as a result is subject to multiple omissions, as well as timing, and accuracy issues. Because key payers and health systems can vary dramatically across geographies, even a 90% data accuracy rate can result in critical errors in key markets.
  
  For this reason, validation of third-party data by informed account teams remains a necessary (albeit chaotic) activity. Similar to data capture logistics discussed above, manual validation processes remain problematic. Reliability becomes hazy in terms of when things were last validated, by whom, and what actually changed. Compliance also becomes increasingly important if any overrides are applied, with detailed business rules around language used and documentation required for both internal and external data sharing. And this cycle continues indefinitely, requiring frequent review for changes and updates that can become burdensome for all involved.

A Framework for Access Data Excellence

Now that we have outlined common data management issues, we turn to suggested best practices to fully leverage available market access data and confidently deliver impactful information to all stakeholders. To maximize ROI on data assets and inform optimal strategies and tactics, market access data assets should have the following 5 characteristics. You can reference the accompanying questions to help identify where your organization currently stands in its data management evolution.
 

Confirm that your data is:​​