Kevin Cast, Partner, Archbow Consulting

As the pharmaceutical landscape evolves, ensuring market access should remain a top priority for industry stakeholders. As we look ahead to a year of expected advancements, several key trends will shape the landscape for manufacturers and key players. Here are four trends that will significantly impact market access strategies in 2025:

1. The Impact of Digital Health on Market Access

Artificial Intelligence (AI) and Digital health technologies are revolutionizing Patient Support Services and transforming how patients interact with the healthcare system. From remote monitoring devices to mobile health apps, these tools can improve engagement, adherence, and patient outcomes. Pharmaceutical companies can leverage digital health technologies to collect real-world evidence, personalize treatment plans, and enhance the patient experience.

Consequentially, the traditional, in-house support HUB model is facing disruption and quite possibly could become obsolete in the next several years. Automation technologies like chatbots and AI-powered virtual assistants can handle a significant volume of customer inquiries, reducing the need for human intervention in many cases. AI-powered tools can also analyze customer interactions, identify patterns, and provide insights that can be used to improve customer service processes.

Gross-to-net (GTN) erosion is a significant challenge for pharmaceutical manufacturers. It refers to the gap between a drug's list price and the manufacturer's net revenue after accounting for various deductions, such as rebates, discounts, and chargebacks.

To address the challenges of Gross-to-net erosion, pharmaceutical manufacturers are exploring alternative distribution and dispensing models, including alternative 3PL and Wholesaler options, innovative dispensing partners that can “meet the patients where they are” and still navigate today’s reimbursement challenges and digital HUBs, and potentially partnering with virtual distribution entities and novel pharmacy models.

By exploring these new strategies, pharmaceutical manufacturers may be able to preserve a positive GTN and ensure the long-term sustainability of their businesses.

3. The Emergence of GLP-1 Receptor Agonists (GLP-1s)

The growth of GLP-1 receptor agonists (GLP-1s) has reshaped the pharmaceutical landscape. Their efficacy in treating type 2 diabetes and obesity has driven explosive market growth, leading to intense competition among manufacturers. This has spurred significant R&D activity, with companies vying to develop novel GLP-1 analogs and innovative delivery mechanisms like oral formulations. The success of GLP-1s has also shifted treatment paradigms, often positioning them as first-line therapies, impacting the market share of other diabetes medications. However, the inflated cost of these medications raises concerns about affordability and access, leading to increased payer scrutiny and pressure on manufacturers to demonstrate significant clinical value and negotiate lower prices. Fueled by innovation and competition, this dynamic market necessitates a delicate balance between accessibility, affordability, and responsible market access strategies.

The rise of GLP-1s has not only transformed the pharmaceutical landscape but also had multiple effects across other sectors. Their efficacy in treating obesity has led to significant lifestyle changes among patients. This includes buying shifts in food and beverage choices and a surge in clothing purchases as individuals adjust their wardrobes to accommodate their new body shapes. This ripple effect highlights the broader societal impact of these medications. It underscores the need for a multi-faceted approach to addressing obesity that considers not only medical interventions but also lifestyle modifications and their downstream consequences.

Fair Market Value (FMV) for enhanced pharmacy services is experiencing a dynamic shift. While a desire is increasing for critical services that directly impact patient outcomes, such as adherence calls, clinical programs, and advanced prior authorizations, compensation for other services is declining. This disparity is particularly evident in data access and startup fees. FMV rates are decreasing despite the growing importance of data-driven insights and the increasing complexity of establishing new programs. This evolving landscape necessitates a nuanced approach to FMV negotiations, with pharmacies, distributors, 3PLs, and patient support service providers carefully evaluating the value they bring to each service and advocating for fair compensation that reflects their contributions to improving patient care and achieving optimal treatment outcomes.

By understanding and potentially embracing these key trends, pharmaceutical manufacturers and industry stakeholders can optimize their market access strategies and ensure their products reach the patients needing them most. As the industry evolves, a focus on patient value, innovation, and collaboration will be essential for long-term success. 

 Archbow Consulting to discuss how our expertise can address your specific challenges.

Kevin Cast, Partner, Archbow Consulting

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