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SM 183A Understanding Managed Markets Report Summary
1.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights Understanding Managed Markets: Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights STUDY BACKGROUND While bio-pharmaceutical companies still direct the Benchmarking Report bulk of their marketing and market research efforts at-a-Glance towards physician customers, the reality today is that Featured Study Participants physicians are rapidly losing their influence over • Abbott Labs patients’ drug utilization decisions. • Alcon • Amgen • GlaxoSmithKline Commercial and government payers are gaining • Jazz Pharmaceuticals importance; third-party payers now manage the vast • Johnson & Johnson • Novo Nordisk majority of prescription drug expenditures. In fact, it is • Sepracor • Solvay estimated that third-party payers in the Managed • Ther-Rx Markets sector currently control more than 80 percent • Xanodyne Pharmaceuticals of patient access to prescription drugs in the United Information Types States. As a result of this shift, commercial success of • 43 Figures and Tables new pharmaceutical products increasingly depends • 24 Data Graphics • 18 Information Graphics upon anticipating the wants and needs of payers. • 14 Best Practices Spotlights This shift, driven in part by the Medicare Combined Participant Facts Modernization Act and Medicare Part D, has Annual Revenues: From $500M to $10B Average of 21 years in Pharma Industry profoundly affected the pharmaceutical industry; and Each average 8 brands in-market many companies are now struggling to adjust to the new order. Companies are refocusing marketing Report Length strategies and revamping business operations to 65 Pages Best Practices, LLC © (919) 403-0251 1
2.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights strengthen their relationships with Managed Markets customers. Pfizer, for example, devoted a separate business division to managed care strategy and access during a reshuffling of its organizational structure in 2007. And industry observers have seen R&D platforms increasingly influenced by anticipated payer response. To succeed within this new market reality, pharmaceutical companies must access payers and build relationships to develop the best possible Managed Markets insights before product launch. Thus, it is vital that pharmaceutical leaders build market research capabilities that are structured and tasked to effectively capture, understand and communicate to their companies the concerns and interests of key Managed Markets organizations. STUDY METHODOLOGY This report provides metrics, executive insights and best practices for the effective operation of the Market Research function that is charged with collecting insights from the pharmaceutical Managed Markets sector. Leaders of Market Research and Managed Markets functions at pharmaceutical, biotech and medical device organizations can use this report to identify tactics and critical success factors for effectively accessing and acting upon the needs of third-party commercial and government payers. This report identifies the Market Research structures and activities that best support the Managed Markets function in gaining payer access and insights around pharmaceutical products, as well as captures executives’ best practices and lessons learned for working successfully in the current payer-driven environment. The report was created using a quantitative survey and field interviews. Best Practices, LLC fielded an online benchmarking survey with managers and executives representing Managed Markets or Market Research functions at leading pharmaceutical and biotech companies. Analysts then conducted in-depth Best Practices, LLC © (919) 403-0251 2
3.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights interviews with selected research participants. The survey and interview collected benchmark data on the following aspects of Managed Markets Market Research (MMMR) organizations: • Current and optimal structure and organizational fit • Effectiveness of current structure • Pre-launch research objectives • Key global MMMR activities with greatest impact on strategic choices • Timing of activities by product development phase • Activities most effective for generating insights • Activities most effective for accessing hard-to-reach partners • Principal drivers of MMMR activities • Percentage of research that is qualitative vs. quantitative • Top Three most important types of pre-launch studies • Anticipated changes in resource allocation levels • Trends in use of vendors to gather payer information • Projected changes in MMMR focus • Best practices and pitfalls KEY FINDINGS AT A GLANCE A number of key findings and insights emerged regarding the effective operation of Managed Markets Market Research organizations within pharmaceutical and biotechnology companies. The following insights can be used to guide bio- pharmaceutical leaders in evaluating and improving their own MMMR operations. No Single Structure Is Optimal: Many structure types can work effectively for the Managed Markets Market Research function, and benchmark partners use several different models. A more critical success factor than the structure type is the level of research staff knowledge and understanding of the Best Practices, LLC © (919) 403-0251 3
4.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights Managed Markets sector. Developing staff specialization and expertise is the key to making any structure begin to work from an MMMR perspective. Manage Resource Competition: Brand team and Managed Markets research projects generally have different targets (physician/patient vs. payer) and find themselves competing for resources and attention. Avoid MM priorities being defused or fragmented through resource competition. This can be a critical pitfall. Don’t Wait Until It’s Too Late to Develop MM Insights: MMMR activities peak during Phase 3, though most benchmark partners are moving to push these into earlier phases. This may prove most viable for breakthrough medicines where pharmacoeconomic differences can be identified, and may prove less effective for me-too drugs, as pushing research earlier may give payers more time to develop strategies against undifferentiated products. Role of Account Managers Is Expanding to Access MM Insight: Account managers’ roles are expanding due to the increase of Managed Markets influence in the pharmaceutical industry today. Account managers are seen by most participants as the most reliable method for accessing hard-to-reach partners. MM account managers play different valuable roles depending on the type of product, its market-entry order, and its clinical profile. Performance Guarantees/ Warranties: Eighty percent of benchmarked companies have explored the concept of offering warranties but most find usefulness limited due to unpredictable patient compliance and complex Medicaid-related CMS submissions. The warranty concept seems best applied for novel drugs in unique therapeutic categories where Medicaid is not a major payer. Best Practices, LLC © (919) 403-0251 4
5.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights PITFALLS AND LESSONS LEARNED AT A GLANCE Benchmark participants shared their collective experience of pitfalls and lessons learned in developing a successful Managed Markets market research function. Among these are the following: • Duplicating research efforts between MM and MR groups. “Managed Markets is not the only group that needs payer research anymore. Brand teams and others are asking Market Research for payer information. If Managed Markets is doing its own research, there can be unnecessary duplication. There needs to be coordination of efforts.” • Believing everything payers say – sometimes they don’t have as much power as they say they do. “When you’re negotiating on tiers, you take some payers very seriously—those with ability to deliver on their access. Others exaggerate their influence. Account managers need to know when they can walk away.” DATA EXCERPTS AT A GLANCE MMMR Structure Can Influence Effectiveness (an Excerpt) Interviewed executives said organizations with dedicated research staff and budgets—regardless of departmental location—are likely to be more effective than those without. Dedication has several advantages, such as: • Allows researchers to develop subject matter expertise • Enables long-term or ongoing projects, where researchers produce regular MM updates • Eliminates competition with brand teams for limited resource availability • Puts the budget in the hands of the people asking the research questions • Reduces potential duplication of work Best Practices, LLC © (919) 403-0251 5
6.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights For smaller companies, dedicated staff for Managed Markets market research may not be realistic; however, MM ownership of a research budget can be a solution. For “I think a lot of Managed Markets’ success comes example, an interviewed executive director of down to where the dollars Managed Markets at an emerging company reside.” –Interviewed Executive Director credited her success to budget access. Figure 2.6 MMMR Structure Can Influence Effectiveness MMMR Structure Can Influence Effectiveness Benchm ark partners described three structural models for the MMMR function. Those using the two models involving dedicated resources noted improvements gained from reduced resource competition and increased subject matter expertise. No Dedicated Resources Dedicated Resources Models When Managed Markets has no dedicated resources for its market research needs, the group Managed Markets Group must compete with brand teams, commercial Dedicated Dedicated MR operations and other organizations for limited MR resources Resourceswithin MM support. This model does not facilitate research within either staf f development of MM subject expertise. Managed Markets or Market Research Market Market Research Department Research Department gives MM without dedicated with dedicated Competing direct MM Resources access MM Resour ces requests for shared MR t o subject resources matter Dedicated experts. MM Resources within MR BEST PRACTICES , ® Copyrigh t © Best Practices®, LLC LLC Successful Access to Hard-to-Reach Payers (an Excerpt) Account management is the approach that best opens doors to hard-to-reach payers, according to survey respondents. More than three-quarters (78%) of study participants ranked account management as “highly effective” for reaching payers. Other approaches were ranked “highly effective” by no more than half the benchmark class. “One-off” informational discussions with payers and peer-to- peer meetings between clinical experts, physicians and contracting specialists each were scored “highly effective” by 50 percent. A third of partners identified Best Practices, LLC © (919) 403-0251 6
7.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights quantitative online surveys and qualitative interviews/focus groups conducted either online or via telephone as “highly effective.” Figure 4.3 Account Manager Provide the Best Access to the Hard to Reach Account Managers Provide the Best Access to the Hard to Reach More than three-quarters of study participants find account managers a highly effective way to access hard-to-reach Managed Markets partners. No more than half rated any other activity as highly effective for access. Q. Which activities are most effective for gaining access to hard-to-reach Managed Markets channel partners? (Rank each activity from 1 to7.) Approaches for Gaining Access Account management 70% One-off” informational discussions with payer (telephone) 40% 30% Peer-to-peer meetings between departments (in person) Advisory board 20% One-off” informational discussions with payer (in person) 20% Qualitative interviews/focus groups (online) 20% Qualitative interviews/focus groups (telephone) 20% Quantitative surveys (online) 20% Quantitative surveys (mail) 10% None of the companies Mock P&T committee 0% in the study Peer-to-peer meetings between departments (telephone) 0% give high rankings to Qualitative interviews/focus groups (in person) 0% four of the Quantitative surveys (telephone) 0% activities. Ranking Scale: 1=Not at all effective to 7=Extremely effective. 37 Copyright © Best Practices®, LLC BEST PRACTICES,® LLC Interviewed study participants shared a variety of tactics and strategies that they use successfully to improve access to hard-to-reach payers. The most widely used of those are employing third-party vendors to ask the necessary questions of payers and focusing on science, industry and overall customer value when interacting with the Managed Markets sector. Best Practices, LLC © (919) 403-0251 7
8.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights ABOUT BENCHMARKINGREPORTS.COM BenchmarkingReports.com is a service of Best Practices, LLC, world leader in benchmarking research and analysis. BenchmarkingReports.com provides vital insights and data from our primary research at a fraction of original project cost. Best Practices, LLC has conducted pioneering benchmarking research for top companies since 1991, providing clients with "Access and Intelligence for Achieving World-Class Excellence." To learn how we can help you find solutions to your current business issues, visit our site at www.best-in-class.com. APPENDIX TABLE OF CONTENTS Table of Contents........................................................................................................................... 1 Figures and Tables ........................................................................................................................ 3 Executive Summary ....................................................................................................................... 4 Introduction .................................................................................................................................... 4 Objective & Research Approach......................................................................................... 4 Project Participants ............................................................................................................. 5 Definitions & Abbreviations ................................................................................................. 7 Key Findings & Insights ...................................................................................................... 8 Structure & Organization ............................................................................................................ 11 Introduction ....................................................................................................................... 11 Organizational Fit .............................................................................................................. 11 Inability to Measure Value Limits Resources for Managed Markets................................. 20 Focus of Managed Markets Market Research.......................................................................... 24 Introduction ....................................................................................................................... 24 Pre-Launch Objectives...................................................................................................... 24 Best Practices, LLC © (919) 403-0251 8
9.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights Study Types ...................................................................................................................... 27 Research Drivers .............................................................................................................. 28 Data Types........................................................................................................................ 29 Effective Activities & Approaches for Payer Access & Insights............................................. 32 Introduction ....................................................................................................................... 32 Activities with High Decision Impact ................................................................................. 32 Best Approaches for Insights From MM Sector ................................................................ 33 Best Approaches to Hard-to-Reach Payers: Access & Insights............................................. 34 Understand and Demonstrate Interest in Customer Issues to Open Payers’ Doors ........ 36 Viewpoints on High-Rated Approaches..................................................................................... 40 Reduce the Size of Ad Boards to Facilitate Better Conversations ................................... 41 Expand Participant Parameters to Increase Advisory Board Diversity and Broaden Perspectives ....................................................................................................... 41 Account Management Viewpoints..................................................................................... 42 Timing of Key Activities .............................................................................................................. 45 Begin Managed Markets Research Activities before Phase 3 to Ensure Clinical Trial Design Produces the Data That Payers Will Request .............................................. 47 MMMR Roles................................................................................................................................. 50 Current Trends in MMMR ............................................................................................................ 52 Companies Are Adapting Slowly to the New Paradigm:................................................... 53 Best Practices, Pitfalls & Success Factors .............................................................................. 57 Participants’ Best Practices .............................................................................................. 57 Pittfalls and Lessons Learned........................................................................................... 60 Appendix: Full Source Data ........................................................................................................ 63 Best Practices, LLC © (919) 403-0251 9
10.
Understanding Managed Markets:
Effective Marketing Research Structures & Activities to Maximize Payers Access & Insights ODER FORM I’d like to order the following Best Practice Benchmarking Report.® ID PUBLICATION TITLE QUANTITY PRICE SUBTOTAL Pharmaceutical New Product SM-176 Commercialization: Preparing for Ordering Market Success 3 or more reports Deduct 10% Options Shipping and Handling: Add $26 ($48 international) per report ONLINE TOTAL benchmarkingreports.com PHONE SHIP TO: (919) 403-0251 Name FAX Title (919) 403-0144 Company EMAIL Street Address bestpractices@best-in- class.com City/State/Country Zip MAIL Phone Fax Best Practices, LLC tices, 6350 Quadrangle Drive Email Suite 200 Chapel Hill, NC 27517 PAYMENT OPTIONS: Check enclosed payable to “Best Practices, LLC” Visa MasterCard American Express Card Number Exp. Date Authorized Signature Best Practices, LLC © (919) 403-0251 10
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