Market access is wrapped in the politics of health The attention politicians and stakeholders pay to healthcare and its challenges is a keen driver of the ease or difficulty companies experience with drug regulation and market access and has implications… Read More »The politics of market access
It is not unreasonable to have concerns about the cost of medicines. Drug costs are usually influenced by government policies on pricing and reimbursement of medicines themselves. These range from simple discount seeking to more complex approaches such as conditional… Read More »Managerial control of medicines cost drivers
Discussions on health literacy are increasing as healthcare providers, clinicians, payers and patients consider what this means for healthcare. Having been involved in launching the world’s first digital interactive health channel in the UK in 2000, one thing I learned… Read More »9 Tribes of the Internet and their health interests
The relevance of value in establishing the positioning of medicines is the new normal for pharmaceutical marketing. Pharmaceutical companies have customers who are highly constrained by whether healthcare system funding is sustainable long term. Remember, payers think epidemiologically and in… Read More »Positioning drugs in markets: how payers determine value
Good decision-making depend on understanding what goals the decisions serve, and what information and processes we will use to make that decision. It is not unknown for decisions to be made in haste, or with poor understanding of the context, or miscontrue external influences.
An example is mismatching the evidence generation process, used to provide clinical research evidence of a product’s value to payers, with the stage of decision-making by the payer. Payer decision-making is a gated, binary process; that is to say, it has a linear structure of stages, and at each stage (gate), it is a yes/no decision. Failing at a gate (getting a no) means the product goes no further. What this process looks like is important. Not understanding it means that the wrong evidence is provided at the wrong time, betraying a lack of understanding of how information is used.
Clinical workflow is also a decision-making process so we need to know how clinical decisions are made. The same applies to how patients make decisions around their use, or not, of their medicines (called adherence).
We also know about the risks of groupthink, and its impact on the quality of decision-making. Methods designed to challenge thinking are important to ensure that the right problems and issues are being addressed. In policy making environments, this involves critical issues as policy making processes usually lead to legislative processes, and the use of instruments (laws, penalties, etc.) to enforce the law: getting this wrong can lead to policy gaming, or non-compliance. Commercially, this can mean that the decisions reflect personal preferences or influences, rather than an evidence-informed assessment of what the real commercial options are. Tools such as Devil’s Advocacy, Red Team are well-established approached used to ensure high quality decision-making.