How Strong is your Market Access Strategy by Professor Brian D Smith

thanks, any problem of

your

s, you are out right? um my group in um group that I work with at harf and the group that I work with at Bor um together we are almost the only academic research group in the world that is studying the evolution of the industry and in particular one aspect of that is the acquisition of

market

access

capacity, so we are a very unusual specialized group in that sense and the majority of our researchers are people who work in the industry who do not because, as the leader of the group, I think that it cannot be You don't really understand the industry unless you work in it to a certain extent, so it's not some kind of academic study in the industry, but rather people who work in the industry are forced to go. through academic rigor and there's an old joke about academics that if you laid them out, if you took all the academics in the world and laid them end to end, they still wouldn't come to a particular conclusion, okay, so I'm going to try it. refutes that tonight by giving you some of the findings from our work in such a way that you can take it home to the office door, take it back to the office and use it in a practical and applied way, so let's try to do that.

I've been on the same presentation skills courses that you've been on um so this is the slide tell them what you're going to tell them um generally speaking, tonight is divided into three roughly equal thirds um about 20 to 30 minutes. each one, the first third, I apologize, will be the conference part and then we will move on to the two parts of the workshop part, um, and in this first part I will try to come to an agreement and show you. Our work develops the idea of ​​defining what

market

access

strategy

is because, as Voler said, you know if you want to talk to me first.

Define

your

terms if I say market access and I mean one thing and you are saying market. access I want to say something else, so we're going to have a pretty sterile discussion about us and I'm also going to try to show you our work there on the differences between

strong

and weak market access strategies, how do you measure it? the differences between

strong

and weak and what those differences are, so that's going to be the first part, then we'll move on to the part of the workshop where I'm going to try to ask you to apply it to a case study and I'm going to ask you to apply it to the case study more relevant and useful that you can apply to and maybe I shouldn't say this as an academic but there is only one case study that is relevant in your business which is your business because all other businesses are different so I will ask you to present your application for a brand that you're familiar with, so we'll apply that and then we'll have the last third. a discussion about the implications of that work and what it means and how it works and if we have time, I'm going to talk a little bit about the broader context of the work because having done this work, the next question I'm asking is why? their pharmaceutical and metch companies, why they are relatively weak and relatively slow in developing market access capabilities, that's what we're going to do, that's the plan for tonight, so I'm going to pause a little bit for a moment so that You can sneak out the back door if you're not interested, but this is what we're going to cover.

I began my research by visiting many high-level executives who direct market access for many large companies in the old sector. Technology and this is just a quote from one of them, we have 10,000 people in the organization and at least as many different definitions of what market access

strategy

is. Everyone knows this movie. If I told you the name, everyone would agree, but to avoid embarrassment, I'm not going to tell you who it was. The interesting thing is that you ask all these managers and they all give you a weak definition and I don't mean that in the sense that I didn't do it. like the definition, I mean it in the sense of a definition that did not pass the tests of a sound definition.

Good definitions are inclusive, exclusive, descriptive, not circular, one slide says so and they all gave very vague definitions, even when you are of this type. In research there is what is called single response bias. You never do research by going to a company and asking one person because you may find someone with a strange point of view, you ask multiple people within the organization and when you ask multiple people within organizations, you get many more definitions and they are never agree and often contradict each other, which is a bit scary, but the research didn't stop there, there was a positive side to this, because even though these definitions were varied and weak, vague and contradictory, it's a bit like being a detective at a crime scene, the crime scene because if you talk to enough Witnesses and you know the context and the background and you know some background information, you can piece things together and get the story from them and that's effectively what what we did, which I'll talk about in a moment, so we put all these definitions together and the first thing that emerges is that you have to understand, of course, that strategy is a cascading process, the definition of strategy is a sustained pattern of decisions of resource allocation and when organizations make strategies, they do so in Cascade, they begin with decisions about what market we should be in and what industries we should operate in.

That is the corporate strategy. Most of us in this room don't care how it's done. That strategy is developed by people far above us who cascade down once it is done to the next strategy to be carried out, it is the business unit strategy, which is the allocation of resources between parts of the market, so, for For example, what areas of therapy they will be involved in and also how they will do it. We allocate resources along the value chain, so are we going to be a research-based Leed company or a client company or a company that focuses on operational excellence?

Those of you who have done an NBA will hear the echoes that report as generic strategies, that's what he was. speaking of the lowest level, once the business unit strategy is made, it is the marketing strategy, which is the allocation of resources between markets within a segment and the allocation of resources between different aspects of value, which should not be confused with the marketing communication strategy, which is a different lower level. strategy below marketing strategy Lies Market access strategy and all other functional strategies such as marketing communication strategies and medical affairs strategy etc. The market access strategy is that set of resource allocation decisions about what health economic value proposition to make and how to allocate resources between the decision makers within the market access decision talk a little more in a second and That, of course, cascades into all of these things like what we would call market access tactics, like the clinical claims that you make, the economic health claims that you can make. the price level the price structure your promotion process how you work with patient advocacy groups, etc., your definitions of market access strategy It is very common that when you ask them to talk about market access strategy, they do not they're talking about market access strategy, Talking about market access tactics, the tactical pattern okay, so this understanding of what market access strategy was and where it fits into the strategic decision making cascade within an organization was, I think, the first, to find the first contribution that our definition of market access strategy, does not yet meet the criteria of a solid definition of market access. strategy, so to do that, of course, we had to say well, what do we mean by market access and what do we mean by strategy and then put the two together, again coming out of the research analyzing what everyone said, putting them together looking for the common? areas of overlap, we came up with a definition of market access strategy, since market access is a situation where, in short, doctors agree to make the product available to patients and there was a high degree of agreement in common, so in the interviews about that, so we took the data, we analyzed it, we put it together in word form, we took it back to the theories of the interview and we said yes, that's what we mean by market access strategy and then that took us.

In terms of what market access strategy and market access strategy means, we confirmed that we concluded that it was a functional level strategy, so that is the second bottom layer in that diagram that I just showed you and it is that pattern sustained resource allocation decisions made with the objective of achieving market access. and involves activity decisions about what health economic value proposition to make to the market and which audiences within the market access decision-making process to whom to direct that proposition may now sound a bit wordy, but it needs to be done to get a definition solid that it is inclusive, exclusive, descriptive and non-circular, this one passes all those tests and was well received by the people we took it to, as far as I know this is the only one published by what I mean a revised definition published and peer-reviewed. of market access and market strategy that exists.

Well, there are many courses in each company. They could say Market Access is this and they could talk about Market Access Strategy. This is the only published peer-reviewed one that I know of and has even been adopted. by isore, which is the European medical device group working on that now, so defining what the market access strategy was was, I think, our second contribution to knowledge, our second finding, but then of course everything What they think about all good research, of course, is whatever you find out, you just answer one question and ask 20 other questions and that led us to this topic of well, if that's what go-to-market strategy is, what What is the difference between a strong market access strategy and a weak market access strategy?

This methodologically is actually very problematic because of course your first instinct is: well, a go-to-market strategy is one that makes you a lot of money, isn't it commercially successful, but it doesn't work? Because, of course, business success is multifactorial. many, many things that lead to business success how good your molecule is how strong your Salesforce was what resource you had how bad your competition is, so you can't just say that a good go-to-market strategy is one that achieves commercial success and the other What we discovered is that market access strategies turn out not to be binary like good or bad, but they turn out to be like people, you know, we all have our strengths and our weaknesses, don't we?

So we started asking this series of questions. and as we progressed we realized that actually what is a good market access strategy is not the right question: the question is what are the dimensions or parameters that can be measured, evaluated or judged by which can differentiate between strong market access. and a weak market access strategy makes sense, what are the things that can be measured? Okay, so if I asked you to measure the quality of anything else, a glass of wine you just had there, you wouldn't say. good wine bad wine you would probably have two or three parameters by which to measure it and we asked this cascade of questions about what is your market access strategy how well it works what what works well what doesn't work how good Some look like the weak and we asked this to several companies and we put them together and there was a lot of overlap between them, some differences, some confusion, but we put them all together as if you were a detective at a crime scene and what emerges is that now there is too much on the slide .

Anyone who has taught me presentation skills would scream at this slide, of course it's too much, but we're going to go over this in the workshop and what we found allowed us to do it. If I look at this very briefly, we found that there were nine dimensions that market access strategies could be compared to and let me pick a couple. I'm not going to read them all, but you already know one of them. For example, it is the degree to which your market access strategy anticipates change in the market, one of them is the degree to which your market access strategy understands that it fits with the life cycle of your product, one of them is the degree to which it recognizes market heterogeneity, well, the key, of course, is good, a strong market access strategy delivers health economic value in the eyes of the peer inst, so there was a set full of these and the beauty ofthese.

Of course, what we got from the data was not just this, but we also got descriptions of well, we're good at this when our market access strategy does this and we're bad at this F, for example, we're good. at F when we do this and we are bad at F when we do that because of course all the companies I interviewed were quite large and they all had experience in many market access strategies, so we have nine dimensions and that Of course, we allowed us to develop a scale, yes, so what you see in that column on the left, which is so difficult to read, are the same words that you read on the previous slide, are the nine factors and what we set out to do.

I was building a qualitative scale where you could describe what was good, bad or different for each of those nine Dimensions. In fact, in my research work, and what and when. I work with companies, we have a five-point scale, for the sake of brevity and simplicity, tonight we are going to work with a three-point scale, but there is a five-point scale. points, and what we were able to do is paint a picture of what is good and bad. and indiff are seen along each of these nine Dimensions so you can see your own go-to-market strategy and say well according to Dimension C by looking at that lane of descriptions the description that most accurately fits our strategy of market access for our brand. it's two and in Dimension D it's five and so on and so on and that led us to this, okay, so if you think the previous slide had too many words about this, it's much worse and of course I don't expect to read this.

We'll look at this in a moment in your handout, but the point of showing this slide is simply to give you an idea of ​​how to do it. If you look along any of those lines, you will see descriptions of gradation. what we found with this and even better with a five-point scale that companies can look at, you know, they write down their go-to-market strategy, they look along these lines and say well, if we're honest with ourselves, this is where we are. and that. It brings me to the secondary value of doing this, of course, because in addition to having some degree of OB objectivity in measuring the strength or strength profile of your market access strategy, it has the benefit of allowing you to discuss it in rational objective terms within your team or if you do it within a company that costs several brands to transfer ideas between teams of brands and that's where the great value comes from and this is interesting because when we came up with that original list of nine criteria and we showed them to the respondents they said Yes, it all makes a lot of sense, so how do you test these things at this point?

We don't and it turns out that market access is probably because it sits in the interstices of multiple function boundaries and probably because it is So important to a brand's success is that market access strategy is a process. especially politicized and is very often judged in a very subjective way, if it is judged in a very subjective and politicized way and, of course, what we were trying to do. What you need to do is get a testing process that removes the politics and subjectivity and gives you the best possible objective testing method. Sorry, excuse me, I don't understand what you mean by a politicized trial and I'm wondering how.

You came to the conclusion that that's why it's not right in the research we asked questions like um, how do you know if your go-to-market strategy is good or not and how do you make the decision to do this versus this? Okay and the answer that came. In the interviews was it, um, was it the result of the person who had the power deciding this or was it the result of a political compromise between person A and person B, yeah, so if you define politics as the use of power in organizations. Which is a pretty standard definition of politics when I say politicized I mean a decision that is reached as a result of an internal power dynamic rather than a rational basis.

Makes sense? Okay, so you know as academics what we use when we use words. like politicizing, we refer to them in a very specific way, you know, but at this point I would like to make a health warning because it is a politicized process and because this process is effectively not one in which things can be measured in a way extremely quantified, if you're not making a series of guided value judgments, it's extremely easy to screw this up and one of the things we saw was that when we handed this over to the companies that we did the research on, they ran away and tried to do it and you know the best possible way to screw it up because of course you have to understand what you're doing.

You know, using this tool if you don't really know what you're doing is a little like giving me a power drill. I know my wife will tell you everything. I'm the worst DIYer in the world so if you give me DI, give me a power drill, it doesn't allow me to do it better, it just allows me to screw it up faster and better, and it's a bit like that with this tool with equipment that They are not trained to do it, they still got it wrong and the problem is that now they have a premature imp, a seal that says, well, we applied a scientific process to this, so you must be right, so making a wrong decision but with great amount of credibility is better than having a bad decision without bad credibility, so this one comes with a health warning, it's kind of don't try this at home.

The result of this process is something like this, a radar chart, so these nine axes that you see on the radar chart, all those nine dimensions that you saw on the chart, nine dimensions that you saw on my slide, okay and You were able to judge them using the graph and get a brand profile, so if you look at the green line on this graph, for example, you will see that they were particularly strong on characteristic a and particularly weak on characteristic e and different bands are different profiles. Again, we come back to this secondary value when doing this process: you can compare brands within your company and say what this brand is doing well that we could apply to that brand and it facilitates the internal transfer of knowledge and it is even better when you have the teams of brand challenge each other, of course, because they say h you give a to us we think you're just a c you give yourself a high grade on a and we think you should get a medium or low grade and you are obliged to justify yourself, but not only according politics and not just subjective opinions on a rational scale, this is what the result looks like and of course the big benefit of this is that improving your market access strategy always requires some kind of resource always requires some kind of effort now, if you look at the green tick on this one, for example, which was at Mark 11 in our work, there's probably not much point in trying to upgrade Dimension to OK or Dimension.

F, but you can have a relatively large impact on the strength of your market access strategy by trying to improve Dimension e or um. Dimension H is fine, it allows you to focus the efforts of your market access team, so in practice, when we use this, you will see benefits if you get an objective evaluation, you will gain internal brand competencies and you will challenge the depoliticization of the process and More importantly, if you are a market access leader, you will get clear direction on where you should focus your effort so that we can This is essentially how the process works, but I can sit here and talk forever about this and still I won't understand you.

The best way we're going to do this, I suggest you have a I got this from a brand that you're familiar with, what I'm going to do is give you some handouts that will allow you to do that. I will ask you to work individually or with a partner, whatever you want to do. and think of a brand that you are familiar with, many of you have written to those you are coming to, you have written to them in advance and warned them about this, think of a brand that you are familiar with and I am going to ask you should write your go-to-market strategy and I'm going to ask you to judge yourself according to these scales look at these scales now, of course, you won't get it right, remember that the goal of this afternoon is not to get the right result.

The goal tonight is to learn the process, okay, and then when we're all done, I'll ask you and you don't have to say what your brand is. You can keep it confidential. I'll ask you to write it here, I'll see how you look, is that okay with you, in that case I'll show up and we'll go into the workshop, thank you.