Why understanding your stakeholders’ different definitions of value is essential for UK market access success
By: Robert Taylor | November 12, 2014
Proving value is hardly a new objective for biopharma. In the commercial world, it would be unforgivable to send a product to market without being absolutely sure you could demonstrate real value to providers, payers and patients. Get this wrong, and you risk losing market share and profits.
The approach therefore is clear: find out how your stakeholders define value, and mirror it. That should be a relatively simple task, and until recently, it was. The UK, for example, had a single market access gatekeeper; NICE, so aligning with its definition of value was essential. But since the 2013 NHS reforms, there are now hundreds of local budget holders with unique unmet needs and potentially vastly different definitions of value.
So where do you start? Part of the answer must lie in the 'triple aim' of improving population outcomes, enhancing quality of life and lowering healthcare costs. By focusing on these three value drivers you build a solid case that can appeal to all stakeholders. Though clearly, the 'triple aim' is just the beginning and fine-tuning for local needs is still paramount, companies must craft multiple locally relevant value propositions for every product. Only once they understand the nuances of a local healthcare system and the value of their product, can they communicate how a medicine might fit into care pathways, and how it can improve outcomes.
Perceptions of value
If pinpointing the definition of value is a fundamental step towards commercial success, then it is worth spending some time analysing current beliefs. Quintiles carried out an extensive survey of close to 300 healthcare industry executives, and the results published in our ‘Value is the Target’ report make for interesting reading. The survey revealed a major disconnect between how stakeholders define value and how their peers think they do.
We gave them seven definitions of the value of a pharmaceutical product and asked them to choose the ones that best describe their organisation's priorities. Biopharma, payers and providers were all most likely to put 'degree of improved efficacy over current products' in their top two. Clearly this is an encouraging start, but opinions then quickly diverged.
Providers were most likely to choose 'improved quality of life' as their top definition (34%), yet just 11% of EU payers felt the same. Global biopharma executives were undecided: 32% selected 'unmet medical need', 21% chose 'improved quality of life', and 20% chose 'degree of improved efficacy'.
Crucially, most stakeholders didn't put 'cost compared with existing products' high on their list, and a quarter of biopharma executives ranked it at the bottom of their top five (only 8% of executives ranked it top). Yet this value driver cannot be forgotten completely, as EU payers and providers regularly place cost in their top three definitions.
The implication for biopharma is that if companies fail to measure cost in relation to outcomes as part of their future research and communication strategies, it is likely to impact their long-term business potential. There was a time when any safe and effective treatment could achieve a degree of success even if priced at a premium, but that's simply no longer the case. Biopharma must communicate comparative efficacy, cost effectiveness and affordability if they want their products to become widely adopted.
Define your terms and take action
There is no doubt that defining value has become hugely more challenging for biopharma. In the UK alone, there are now 211 clinical commissioning groups holding budgets, and each one may judge your product with a different measuring stick. And that's before considering the complex healthcare economies in the major European markets. Using the triple aim structure is therefore now essential.So what are the practical steps you need to take?
In the world of market access, defining value may well be the most valuable thing you do.
To read the full ‘Value is the Target’ report, a stakeholder survey of perceptions of value in healthcare, click here.