In this guest article by Richard Mee and Andrew Hobbs from BaseCase partner Pope Woodhead, the authors explore the essential foundations needed for success – and define the leadership role now required from health economics and market access.
Pope Woodhead is a multi-disciplinary consultancy based in Cambridge, UK with specific expertise in value story development and local payer engagement. Having worked with BaseCase on several projects, the two companies have established a collaboration aimed at driving joint thought-leadership around the evolution of gold-standard value communications and broadening the scope of services each group provides.
Where does ‘value communications’ actually sit?
The increasingly fragmented local payer landscape in many key markets is causing a damaging disconnect between strategy-makers in pharma company headquarters and the needs of their key local customers. The task of engaging and communicating with local payers about a product’s value still lies with local teams; who use their local market knowledge, but who are often not equipped with the right information at the right time, or the necessary skills to communicate a product’s value proposition effectively to a payer audience.
By contrast, the health economists and market access specialists based in global and regional company HQ, who are key to developing launch strategies, value propositions and supporting economic evidence, lack necessary local insights.
In addition, the development of payer-focused value communications materials is commonly the task of health economists; a group commonly equipped with strong academic verve and an ability to assimilate large volumes of evidence, but who may not possess the skills needed to develop concise and compelling value stories that can be adapted to an increasingly broad spectrum of local customers.
Even where the competence does exist, there is often too little time allowed to develop and refine a robust proposition and value story. A quotation often attributed to Mark Twain nicely sums up the situation: “I apologize for the length of this letter but I didn’t have the time to write a shorter one”.
As the needle of ‘relative customer importance’ continues to swing out of the prescribers zone and towards fragmented local payers, conveying a product’s value to the payer must now be a priority not just for market access but for all of marketing. In this scenario, the fact that health economics (HE) remains a critical influence for payer audiences, and the lack of understanding of HE beyond departmental walls means the commercial importance of HE is likely to increase in the short term.
So where is this heading? And what should health economists and market access executives do?
When new technologies emerge from discovery and enter human trials, cross-functional teams are established to lead the development and commercialization strategy. Historically, these teams have sought to develop a common understanding of the product positioning, the Target Product Profile and the planned clinical development program necessary for regulatory approval. Given the shift of emphasis towards reimbursement alongside regulatory approval, the focus of these teams is now moving to understanding the value positioning, the Target Value Proposition and guiding the overall evidence generation program based on agreed launch and lifecycle strategic objectives.
Market access and HE participation in these cross-functional teams is increasingly important: in some forward looking companies, the value related functions are starting to take on leadership or coordinator roles. However, even if such leadership can be established in HQ, it is still the case that surprisingly few companies have effective systems in place to actually manage their internal alignment.
Therefore, in order to support a leadership position in the consideration of value in product development, and the subsequent communication of value, two objectives should be prioritized:
- Ensuring all internal stakeholders (both HQ and local teams) are aligned to the payer value proposition as early as possible.
- Enabling local teams to adapt and optimize their own value communications for payer engagement.
Achieving these objectives may require new platforms for internal collaborations and new tools to convey value to customers. Both can have an enormous impact if properly executed and will most likely require enterprise-wide adoption and investment so they can be transferred from one brand to the next.
Key considerations in achieving these objectives
‘Framing the value proposition and laying foundations for ongoing communication’
There are many ways to frame and visualize a product’s value proposition; whichever is chosen it will involve messages about treatment landscape and context, patient profile and clinical benefits, economic benefits, and potentially wider environmental or societal benefits. This ‘classical’ message structure (represented here) is not new, and can be used for the purposes of early internal alignment.
In early development, some of the messages may be aspirational with evidence requirements defined but pending later RCT data; all of the messages are important, as they outline how you will position the product and present its value to the external audience.
‘One platform to unite them all’
Most companies possess sophisticated intranets: web-based internal communication channels that link teams, departments and entire companies.
Such internally-focused communication channels can be used effectively to convey information about a product within an organization. In fact, in the singular task of conveying information about a new product, they share a similar purpose as the external tools and presentations used by KAMs in their interactions with payers.
So is there a potential efficiency gain in ‘joining’ internal and external communications through a single platform? Some companies are exploring the possibility in order to:
- Provide an environment where the value proposition and supporting tools can be framed and developed over time using feedback from internal stakeholders.
- Ensure the latest tools for external use are available and customizable.
- Monitor external usage and stimulate feedback.
- Provide guidance for use of the global resources and tools as well as adaptation support and governance mechanisms for local use.
A scalable platform, owned and managed by the market access teams has a number of wider benefits in addition to efficiency:
- Common platform for all assets with local adaptation capability.
- Earlier alignment of HQ-based functional stakeholders.
- Earlier and simpler engagement of local country teams.
- A forum for internal communication.
- Control and governance mechanisms built in.
- Reduced training burden for country-based customer-facing teams.
The process for creating a common communications platform is set out below:
Pope Woodhead and our strategic partner BaseCase offer a new solution to this type of platform development objective whereby a toolkit is designed with internal and external functionality in mind from the outset; combining both static file sharing and interactive data calculation ‘tools’ in a single resource that is adaptable to a wide variety of hardware. Using BaseCase’s software also delivers the benefits of a ready-made and extremely effective content management system, which allows customers almost total freedom to self-develop their tools to adapt for new markets or to add new data. This removes the need for delays and on-going costs whenever the deliverable requires updates.
Improved local customer engagement
So the platform is in place. But what about the customers themselves? It’s no secret that the customer landscape is becoming increasingly more complex and is constantly fragmenting. Added to this is a huge pressure on timing; it has long been known that starting market access preparations earlier in a product’s development can improve the success of the launch; but traditional barriers to intensive early activity – budget constraints, risk of program termination and lack of executive time availability – still largely remain. So what can HQ-based health economists and market access teams do? The focus must again be on improving efficiency.
How many companies have a truly end-to-end, transparent customer engagement framework covering all their affiliate teams? Surely in an optimum scenario, country teams will be able to use their existing local expertise to plan market access activities based on a common global customer engagement framework, with the potential for timely feedback to HQ.
Too often, companies operate in a disjointed way; country teams are set objectives with little focused assistance from HQ. HQ teams themselves find it difficult to get really involved due to the constraints outlined above, and many who have tried have been put off by countries lack of engagement. In addition, there is often a natural ‘hierarchy’ of countries; with high sales developed markets – most notably the US – exercising far more autonomy over their activities and approach to payer communications than smaller countries, making it difficult for HQ to stay in control.
Again; the most forward looking companies have recognized a need to address this lack of coordination and transparency. But they have also taken steps not to lose or restrict the unquestionable value of their affiliate’s local knowledge. They have achieved these potentially opposing goals by installing global customer engagement frameworks.
The true value of such frameworks is their simplicity. Indeed this is an essential condition of their adoption by affiliates. They act as guides for local behavior rather than offering mandated processes and deliverables, can adapt to different payer structures and they provide the blueprint for a global customer engagement model sharing a common timeline and providing much improved transparency for HQ teams.
An example of a simple engagement framework is illustrated below; these should be adapted to each organization based on company cultures, strategic goals and emphasis on aspects of the engagement process that may currently be weak and need particular attention:
Adopting simple, high-impact tools provides a solid foundation for payer communications before any specific messaging or channel decisions have been made. These tools will serve to maximize efficiency as well as provide transparency for the benefit of all product launch programs.