Adopting a transformational approach to market access and pricing decision-making
Market access headwinds and the use of AI
In today’s rapidly evolving global pharmaceutical environment, market access executives face unprecedented challenges, including gross-to-net pressures and price controls in the U.S. and significant post-Covid budget restrictions outside the U.S. We are at a crossroads to find incremental value opportunities to counter a system that is “bent out of shape”.
Payer empowerment, integration and negotiation leverage, the increased role of the medical community, providers and patients in promoting access, the requirement to balance global access needs with transparent pricing and the push for “fair pricing” are only some of the challenges pharma faces in a constrained resources environment.
At the same time, the data, infrastructure and technology landscape (including a wealth of data sources, tools and AI) has been completely revolutionized in the last few years, and there are no benchmarking standards to inform what “good looks like”.
Effective decision-making requires appropriate processes, people, tools and systems. Otherwise, efforts may be wasted due to a lack of data and analysis, wrong targets, problem definitions or lack of ownership.
A recent ZS benchmarking study indicated that market access, pricing analytics and AI adoption are among the key dimensions lagging compared to other commercial functions within pharma organizations.
Market access and pricing (MA&P) capabilities are lagging due to:
· Lack of a data lake or hub infrastructure to aggregate structured and unstructured data
· Lack of pre- and post-deal optimization and business processes, multiple tendering and tracking platforms
· Misaligned value and access performance tracking
· Limited automation and use of AI
· Lack of clarity on governance processes
· Burdensome pricing policy review process
· Lack of sign-off tracking procedures for access and pricing deliverables
Urgently, companies must move on from leveraging legacy tools and adopt a transformational approach to analytical pricing decision-making, including incorporating generative AI (GenAI).
But where should pharma executives even start with GenAI implementation? And, how difficult is it to understand how GenAI implementation will impact relevant people, processes and tools?
Staying ahead of the curve requires two critical components:
1. A diagnosis toolkit to identify where your company is along the MA&P analytical maturity journey
2. An actionable roadmap providing effective solutions to address gaps
Diagnosis: The ZS Value & Access analytics maturity model
ZS has developed a 6-dimension Value & Access capability maturity model to help pharma leaders conduct a diagnostic exercise and evaluate their market access capabilities to assess if the current approach is “foundational,” “advanced” or “transformational”.
For example, a “foundational” analytics infrastructure offers limited consistency between infrastructure and systems, with partial documentation of strategic tradeoffs across pricing and access strategy development, and teams conduct analytics on an ad-hoc basis at the product level (e.g., Excel reports).
An “advanced” analytics infrastructure introduces standardized systems and methodologies for contracting needs, such as regularly updated asset dashboards and modeling tools, while a “transformational” analytics infrastructure includes a more robust set of tools, including a central repository to house, consolidate and integrate data across systems.
Outputs of this diagnostic exercise align pharma’s ways of working into specific archetypes, with “drivers”, “democratizers” and “disruptors” being the most common.
Drivers:
· Identify high-quality MA&P insights that drive strategy development
· Clearly articulate governance structures to inform roles and timelines for decision-making
Democratizers: (majority of Big Pharma)
· Develop an integrated data and analytics platform and products for strategy development
· Leverage assets and products that enable standardized approaches to MA&P actions
Disruptors:
· Evaluate disruptive and cutting-edge solutions
· Strategize around transformative ideas and partnerships
· Launch an enterprise-level innovation center of excellence that enables custom strategy creation
These archetypes can help market access executives define common pitfalls and success factors and determine where to move the needle on key elements of transformation.
Actionable roadmap: Solutions and success drivers
Our benchmarking study identified several success drivers from best-in-class organizations on MA&P analytics and strategic capabilities, which span across processes, tools, systems and people.
Process
· Apply consistent approaches to support pricing strategy decision-making
· Include a set of KPIs to clearly map results against a standard process
· Follow specific governance processes (e.g., governing charters, guiding principles)
· Offer learning platforms for continuous improvement to remain relevant and effective
· Stimulate collaboration between cross-functional team members
Tools and systems
· Deploy the latest technological advancements (including nearshoring, offshoring and AI) to create efficiencies and increase focus on trade-offs analysis and pricing decision-making
· Automate insight generation (e.g., consolidating web data to guide pricing) and reduce the need for repeat research
· Digitize content (e.g., interview notes) to prepare and expedite data for deep analytics
· Integrate within your existing tools and systems ecosystem
· Scale across business units and context
· Orient decision-making around user friendliness
People
· Integrate a common language, set of behavioral expectations and indicators for how to operate in agile, fluid environments
· Focus on developing true all-rounders individuals equipped with technical and adaptive capabilities
· Develop strategic agility and maintain an impact-oriented mindset
· Facilitate flexible models leveraging automatization and nearshore or offshore resource allocation
· Develop trust in selected internal and external experts for specific topics (advertise and maintain a list of go-to resources
While every situation requires different solutions, we have identified potential avenues to help support adopting a transformational, AI-focused approach to MA&P analytics.
Reach out to ZS to learn more about adopting a transformational approach beyond legacy tools!
