No matter how strong the portfolio, every pharmaceutical company has at least one product that’s the straight-B student.
Each quarter, the brand struggles to achieve the reimbursement levels necessary to meet its forecasted revenues. Under such scenarios, it can be tempting for each part of the organization to point the blame at another team. For example, executives from the managed markets team might argue that contract terms aren’t competitive, while payer marketing may assert that account managers are focusing their energy on other brands.
The truth is, the factors driving a brand’s underperformance with payers are often more difficult to uncover. But these drivers can—and should—be identified as quickly as possible, so that the brand team has the best chance of turning around results.
Assessing how your brand measures up in these areas can actually be a fairly quick process. Within a matter of weeks, a brand team can have a clearer picture of the opportunities available to enhance its success in managed care. To achieve that clearer picture, brand teams should look at these six causes of underperformance with payers.
1. Inadequate Product Value
How does a brand team get its product to “matter” to payers? The key is to maximize product value to payers.
- Can your brand claim advantages on product attributes that are meaningful to payers?
- Do you know where competitors fall short on addressing payer requirements?
- Has your team invested in research with payers to identify (and validate) opportunities to differentiate your product and best address payer requirements?
2. Incomplete Account Segmentation
Have you segmented accounts or simply chosen targets? It can be easy for brand teams to think they are targeting the “right” accounts, but often brand teams fail to focus on those with the greatest value to their product.
- Have you established a framework to target and segment accounts for your product? And have all stakeholders bought into the framework?
- Does your segmentation describe payer behavior for your competitive set and explain the beliefs and attitudes that drive it?
- Can marketing and national accounts use the segmentation to assign specific resources to accounts that represent the best opportunities for you to pursue?
3. Ineffective Pull-through
Do access advantages for your brand result in market share advantages? If not, then the problem is pull-through.
- Are physician messages aligned with payer strategies?
- Are your national accounts team and field team aligned on the customer targets, messages and approaches for pull-through?
- Does the field understand how to effectively deliver pull-through messages?
4. Misguided Payer Messaging
Do you have payer-specific messages, and are they impactful? A brand team must continually measure the impact of its messages on payers and identify product information that matters most to payers.
- Does your brand have payer-specific messages that positively affect customers’ behaviors?
- Are you focusing on the “right” messages that convey your product’s unique value to payers?
- Does the outcomes information you share differentiate you enough from competitors?
- Are you aware of what messages payers receive most frequently from your account team and competitors’ account teams?
5. Ineffective Message Delivery
Are payers hearing your message loud and clear? You need to know because you can’t expect high performance if payers don’t recall your product messages.
- Do you know which of your product’s payer messages resonates the strongest with payers?
6. Unsuccessful Contracting
Have your contracts secured access advantages at the right plans? More than ever, contracting is crucial to a brand’s performance, and contracting with the right plans the right way is a game changer.
- Does your contracting strategy define when it is worth the investment to establish a contract with a payer and when it’s more profitable to walk away?
- Have you identified the specific contracting elements that payers value most?
- How are competitors structuring their contracts?
Payer Strategy Self-Assessment
Typically, brand teams struggle with one or more of these six major pitfalls. Is your brand’s payer strategy on solid ground? Find out with this self-assessment. Read each question and assign an answer of “Yes”, “No” or “Unsure.”
1. Can your brand claim advantages on product attributes that are meaningful to payers?
2. Has your team invested in research with payers to identify (and validate) opportunities to differentiate your product versus competitors and best address payer requirements?
3. Have you established a framework to target and segment accounts for your product?
4. Does your segmentation describe payer behavior for your product’s competitive set and explain the beliefs and attitudes that drive it?
5. Do access advantages for your brand result in market share advantages?
6. Are your national accounts team and field team aligned on the customer targets, messages and approaches for pull-through?
7. Does your brand have payer-specific messages that positively affect payers’ behaviors while maintaining alignment with your physician messaging?
8. Are you focusing on the “right” messages that convey your product’s unique value to payers?
9. Does the outcomes information you share differentiate you enough from competitors?
10. Are you aware of what messages payers receive most frequently from your account team and competitors’ account teams?
11. Have your contracts secured access advantages at the right plans?
12. Does your contracting strategy define when it is worth the investment to establish a contract with a payer and when it’s more profitable to walk away?
SCORING: Count the total number of “Yes”, “No” and “Unsure” answers.
10 or more Yes = Your payer strategy is on SOLID GROUND. Continue to monitor and refine to ensure optimal performance.
6 to 9 Yes = Your payer strategy is STRONGER THAN MOST, but you still have some room to grow. Review your “no” and “unsure” answers and identify priority next steps.
Less than 6 Yes = Your payer strategy is a WEAKNESS for your brand. Review your “no” and “unsure” answers and identify priority next steps.
