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How are drugs brought into patient hands

Meet Malwina Hołownia-Voloskova - PhD, health economist, Health Tech Assessment (HTA) specialist and market access consultant. She's worked with all the big pharma companies including Roche, Pfizer and AbbVie. We sat with Malwina to learn about market access which is how a healthcare product or service ends up in the hands of providers and patients.


What is the purpose of market access strategy?

Market access strategy is a way to get health technology, such as drugs, vaccines, models of healthcare, and medical devices, from the manufacturer to the right patient. This can be done with or without reimbursement from governmental or public funds. The goal of market access is to ensure that the right patient receives the health technology they need.

Can you give us an example of a product and a service for which you did the market access strategy?

Sure, one of my favorite cases is Ocrelizumab, a drug used to treat multiple sclerosis. This drug was used to treat both remitting and primary progressive forms of multiple sclerosis, the latter of which had not had any treatment options until then. Through our HTA and market access strategy, we were able to provide the primary progressive patients with a treatment other than best supportive care. Ocreloizumab was more expensive for the public payer but we were able to show that the drug would save money in the long run, as it would not require the purchase of other drugs. We were one of the first in the world to introduce Ocreloizumab.

An example of service is the Biaskin test for Tuberculosis, which was much more effective than the Mantu test that was previously used. We were able to show the payer that it was more economically effective, and despite the strong lobby for the Mantu test, we were able to secure a large amount of savings. It is very satisfying to be able to get savings for patients in this way, and I believe that health technology assessment and market access strategies should be created with the well-being of patients in mind.

What are the key elements of a market access strategy?

The biggest element is patience. You gather data, communicate with stakeholders, ensure that the medical technology is appropriately priced and reimbursed, and make sure that the patient is eventually able to access the drug or medical technology.

The finality is the patient, but do you also consider providers in market access?

Yes, it's important to consider the provider too, such as hospitals and clinic networks, as this is the way to get the technology to the patient. For example, last year I was working on a market access strategy for the use of artificial intelligence in lung cancer detection. As part of this, I was looking for hospitals that could use the artificial intelligence.

How important is the value message in market access?

The value message is an essential part of any market access strategy. It is the key message that is communicated to stakeholders. It's also used to create Health Technology Assessment studies and other strategies. Therefore, it is important to ensure that the value message is clear and concise.

How do you create this value message?

If it's a drug, I look at the data available, such as randomized clinical trial data, systematic reviews and meta-analyses. I compare the drug to existing drugs on the market to determine how it is more effective or safer than already reimbursed drugs. If it's a system, like the AI I mentioned earlier than I quantify cost savings. It depends.

It seems that a big part of the value message is pricing and reimbursement. Do you have a say on that too?

When it comes to finding the right pricing and reimbursement levels, it is important to remain impartial and unbiased. This means that the person responsible for providing health technology assessment or value messages should not be involved in the pricing process or negotiation process. Instead, they should focus on gathering data and remaining fair and impartial with all the data. For pricing there is a separate pricing committee at the company level and a pricing negotiation committee the Ministry of Health level.

What would be the market access strategy for complimentary and alternative medicine (CAM)?

The market access strategy for complimentary and alternative medicine should focus on its safety profile, as this is the most important factor for patients. It would be important to consider any potential restrictions or risks associated with the treatment such as very limited addiction risk. It is also important to note that these treatments are often cheaper than more traditional therapies, which can be another major factor in why patients choose to use them. Yes, the value message should be that the CAM therapy is safe and cost-effective.

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