Securing Market Access: Reimbursement, Payer Relationships and Healthcare Reform

Table of Contents

Metrics Overview

Securing Market Access' three chapters include structure, budget, staffing and key performance metrics data collected from 20 top pharmaceutical and biotechnology companies.

Strengthening Payer Relationships through Communication

Percentage of all companies specific targeting managed care institutions, by type of account:

• Commercial managed care (MCOs)
• Medicare/Medicaid (federal and state)
• Long-term care
• Industry/trade
• Federal markets (DoD, VHA)

Percentage of companies targeting managed care groups, by portfolio type:

• Primary care (companies that develop and/or market a majority of primary care products)
• Specialty (develop and/or market a majority of specialty products)
• Product-Balanced (manage a relatively even-split between primary-care and specialty products)

• Ranking of importance for managed care institutions
• Ranking of importance for managed care institutions, by portfolio type (primary care, specialty, and product-balanced)
• Development phase during which companies initially contact payers
• Number of contacts with payers during each phase of development
• Payer interfaced per phase by portfolio type (primary care, specialty, and product-balanced)
• Percentage of companies' preferred methods of communication with payers, by phase: email, telephone, face-to-face
• Year after drug approval that communication with payers stops

Managed Markets Structure, Staffing and Budgets

• Percentage of companies with formal managed markets departments
• Departments in which managed markets groups typically reside
• Average staff size of a managed markets department (in FTEs)
• Average staffing allocation of a managed markets department' s personnel
• Average managed markets FTE allocation by portfolio type (primary care, specialty, and product-balanced)
• Average FTEs per product ratios by portfolio type (primary care, specialty, and product-balanced)
• FTEs and FTE-to-product ratios by portfolio type (primary care, specialty, and product-balanced)
• Account manager FTEs by product focus and type of account
• Account manager per product by company and type of manager (regional account managers or national account managers)
• Percentage of companies that organize account managers by geography, by portfolio type (primary care, specialty, and product-balanced)
• Average budget for a managed markets department
• Average budget allocation for a managed markets department
• Average budget per product ratios by portfolio type (primary care, specialty, and product-balanced)
• Budgets by portfolio type: primary care-product-focused (as well as specialty-focused and balanced) companies - also per product
• Managed markets marketing budget allocation by portfolio type (primary care, specialty, and product-balanced)
• Managed markets sales manager budget allocation by portfolio type (primary care, specialty, and product-balanced)
• Managed markets account manager budget allocation by portfolio type (primary care, specialty, and product-balanced)
• Managed markets administrative budget allocation by portfolio type (primary care, specialty, and product-balanced)

Healthcare Reform and its Impact on Managed Markets Teams

• Cost ranges for comparative effectiveness research
• NICE' s probability of Rejection vs. Cost per QALY

Additional Data

• Percentage breakdown of all healthcare spending by payers
• Average costs for pharmacoeconomic research