Medical Affairs’ Critical Role in Payer Interactions

However, Medical Affairs organizations often face challenges in the planning and management of payer engagement and market access activities. Best Practices, LLC undertook this benchmarking study to understand the role of Medical Affairs in critical payer interactions and highlight strategies for building and maintaining effective relationships with payers.

Additionally, the study provides benchmarks around the required resource levels, talent acquisition and training for creating effective payer relationships, and payer segmentation and prioritization.

Study Snapshot

Best Practices, LLC engaged 29 executives from 27 leading biopharmaceutical companies for this research. Eleven research participants represented large biopharmaceutical organizations, while 9 participants represented medium companies and the remaining benchmark class emerged from small companies. Also 17 companies form a US-only segment, while 12 companies form a Global segment.

Key Findings

· Capturing Payer Insights: Medical Affairs plays a critical role in probing payer needs and perspectives. The top three activities that Medical Affairs groups design and manage are:
Ø Clinical presentations and discussions with payers (used by 100% of the benchmark class)

Ø Advisory boards / forums for payers (used by 93% of the benchmark class)

Ø Outcomes research presentations (used by 90% of the benchmark class)

· Payer Field Resources and Trends: Seventy-six percent of the participants don’t’ have specialized health outcomes liaisons to interact with payers. A majority deploys medical science liaisons to the field in order to build and maintain relationships with payers.

Table of Contents

§ Executive Summary, pgs. 3-10

ü Research Overview, pg. 4

ü Participating Companies & Segmentation, pgs. 5-6

ü Key Recommendations, pg. 7

ü Key Findings & Insights, pgs. 8-12

§ II. Field Resources for Payers, pgs. 24-30

§ III. Talent Background and Training, pgs. 31-39

§ IV. Knowledge Sharing, pgs. 40-48

§ V. Payer Segmentation and Prioritization, pgs. 49-54

§ VI. Medical Affairs and Payer Resource Ratios, pgs. 55-58

§ VII. Medical Affairs Leadership and Structure, pgs. 59-62

§ VIII. Demographics, pgs. 63-65

§ IX. About Best Practices, LLC, pgs. 66-67

List of Charts & Exhibits

§ Critical elements of strong payer communications
§ Role of Medical Affairs professionals in carrying out activities designed to probe payer needs and perspectives

§ Success factors for strong payer teams

§ Number of projects or studies to be conducted by Medical Affairs organizations in collaboration with payers by the end of this year

§ Effectiveness of payer and market access services at different product lifecycle stages

§ Critical factors for payers in partnership decisions

§ Type of field-based resources deployed by Medical Affairs organization to support payers

§ Market access and payer activities staffing trends

§ Frequency of access to payer or market access organizations

§ Impact of product portfolio diversity on Medical Affairs groups’ access to key payers

§ Effectiveness of staff’s educational backgrounds for payer services

§ Effectiveness of staff’s experiences for payer services

§ Necessary qualifications for success in payer communication

§ Scope of training for Medical Affairs employees serving payers

§ Critical success factors for strong communication with payers

§ Knowledge sharing via an internal group

§ Collaboration of Medical Affairs group with supporting functions that directly interact with payers

§ Knowledge sharing channels and their effectiveness

§ Collaboration with field-based teams

§ Effectiveness of segmenting payers by listed criteria and strategies

§ Importance of different influencers/payers on market access

§ Medical Affairs spend as percentage of total revenue

§ Medical Affairs spend per Medical Affairs FTE

§ Payer staff as percentage of total Medical Affairs employees

§ Current structure of participants’ Medical Affairs organization

§ Leadership for thought leader management