A therapy can clear the regulatory bar for safety and efficacy and still face a very different test at the reimbursement desk. But what happens when several therapies to treat a specific condition approach launch with broadly comparable clinical profiles? As competition in the pharma industry intensifies, health technology assessment (HTA) and payer decisions are becoming important aspects of market access. Yet these decisions are rarely uniform; because evidence requirements, assessment criteria, payer priorities, and decision-making authorities can vary significantly across markets.
For our client, a global biopharma leader with an established inflammatory bowel disease (IBD) franchise, understanding where the competition was coming from was not the core issue. The bigger challenge was to understand where competitive pressure could translate into reimbursement risk, which patient segments & geographies were highly exposed, and how its existing clinical and economic value proposition would stand up.
What Were the Key Hurdles Client Encountered?
The health technology assessment landscape is very fragmented. Regional authorities worldwide have different evidence requirements, assessment methodologies, and reimbursement criteria. This made it difficult to develop a consistent market access response across different countries.
At the same time, the client lacked a consolidated view of market exposure. Because, without identifying the market segments that were most vulnerable to upcoming launches, resources risked being spread across geographies where the competitive threat was not equally significant.
Also, there was uncertainty related to competitive positioning. As new therapies gradually enter the launch phase, the client needed more clarity on how its IBD therapy would have a better clinical profile among competitors.
How We Turned Health Technology Assessment Fragmentation into a Clear Market Access Strategy?
We helped the client build an evidence-backed view of the evolving IBD competitive and reimbursement environment, combining clinical and economic benchmarking with payer and health technology assessment intelligence. Through our market-by-market perspective, the company was able to distinguish between markets requiring defensive action and those offering opportunities to strengthen its position ahead of competitor launches.
What Did the Engagement Unlock?
As a result, the client was able to:
- Identify where the IBD landscape was becoming most crowded and prioritize high-risk markets and patient segments.
- Understand how reimbursement decisions are made related to individual markets and strengthen payer engagement strategies.
- Establish a clearer narrative related to safety, efficacy, and QALY in order to build the therapy’s value proposition where it mattered most.
- Move from reactive competitive monitoring toward proactive market access planning.
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