Better management means better market access
How to create unified market access strategies by fostering inter-departmental collaboration
By on Dec 14, 2009How to create unified market access strategies by fostering inter-departmental collaboration
There is little doubt that market access strategies are a must-have in todays more crowded, complicated, undifferentiated and payer-dominated pharmaceutical market. Getting those strategies up and running effectively, though, can be a challenge. This is at heart an organizational management issue, points out Dr. Brian D. Smith, visiting research fellow at the Open University Business School and consultant with Pragmedic. And in the pharmaceutical industry, We need to be smarter at management, he says.
The building blocks of market access strategy, Smith explains, are first to identify a specific value proposition not just the product itself but the whole cluster of associated capabilities, such as patient management and what that value proposition offers to customers. Then you need to communicate this proposition to payers and other stakeholders in such a way that they will be willing to grant you market access.
The problem is that the traditional, siloed marketing structure of sales, regulatory affairs, medical, marketing, etc was designed for selling pharmaceutical products in the traditional way. Gaining market access for a value proposition involves drawing on expertise from across all of these functions, with a high degree of interdependence. The more interdependence there is, the more people are obliged to work together, and the more potential there is for conflict, Smith notes.
Managing this kind of cross-functional working is a complex, messy knowledge problem that has been around for years, he adds. And there really is no off-the-shelf solution. Much of the challenge, Smith suggests, has to do with organizational behavior. Yet managers in the pharmaceutical industry persist in applying an over-simplistic positivistic approach that reflects the preponderance of technical backgrounds in the sector. For Smith, organizational management is more of a human than a mechanical process although at the end of the line, the industry is still expected to deliver solutions.
While much of the behavior that muddies cross-functional working to the detriment of market access is essentially hard wired into human nature and organizational structures, it can still be moderated productively, Smith believes. This involves a lot more than banging heads together whenever inter- or intra-departmental conflict rears up. Rather than aiming at generic remedies, managers should be thinking about a contingent solution, one that fits the context, he proposes.
The necessary levers consist in reducing pressure pointssuch as information-withholding, divided loyalties (e.g., between team and company), failure to understand attitudinal differences (e.g., more rigid in regulatory affairs, more fluid/ad hoc in sales), perceived inequalities in status, and lack of clarity in decision lines or transparency, and feedback in decision-making.
For example, Smith comments, if you insist on putting medical affairs staff up on a pedestal, everyone else will inevitably want to take them down a peg or two. Goals need to be proximate rather than ultimate and you have to get all the bits right. While he acknowledges that areas of commonality exist between companies in the way they manage these functions, the devil is in the 20% that isnt common, Smith warns. There is no such thing as a best-practice company, just pockets of best practice within companies, he observes. Yet large companies continue to get hung up on processes and standard operational procedures that miss the point when the challenge is to resolve, or at least temper, cross-functional tensions in the interests of a unified market-access goal.
The root problem, Smith comments, is that We havent as an industry worked out cross-functional working. And market accesswith its demand for a whole network of competencies, ranging from the more conventional sales and marketing techniques to key opinion leader management, research and development planning, health economics or government relationsis a particularly virulent symptom of this disease.
In Smiths view, there is an urgent need for pharmaceutical companies to shake off their bad habits and get their own houses in order. Otherwise they will remain ill-equipped to address this unnervingly complex and demanding environment, in which companies must not only construct a wide-ranging value proposition but demonstrate it convincingly to a variety of stakeholders with varying agendas.
And how far has industry advanced along this road to date? Smiths answer is a sobering one: Most managers are still at the black box stage. That is, they are trying to manage the problem without an understanding of the research underneath. As with any complex problem, theyd be better off trying to understand first and act second.
For further insights into cross-functional working, please contact Dr. Brian D. Smith at