Market Access: A Patient-Centered Vision
As we have seen in previous posts, the market access In the pharmaceutical sector, it allows therapies to reach the largest number of patients who need them, breaking down barriers of availability and affordability (see: https://ideaxplore.com/barreras-de-acceso-a-servicios-de-salud-en-colombia).
To achieve this goal, the leaders of market access they have mechanisms and approaches that have evolved focusing on patients; for example, Patient Access Schemes (PAS) Patient Access Scheme) which are "innovative pricing arrangements designed to improve profitability and facilitate patient access to specific drugs or other technologies" (1).
Some types of PAS can be price-volume discounts, the maximum expenditure ceiling, the financing of the initiation of treatment by pharmaceutical laboratories or discounts based on prior response, among others (See: https://ideaxplore.com/como-funcionan-los-acuerdos-de-acceso-a-pacientes-en-el-sector-farmaceutico)
The implementation of this type of scheme brings multiple advantages such as:
And some disadvantages that they can present are the management of the data and its confidentiality, an issue that worries the authorities and leads to establishing conditions and requirements for the laboratories that build these proposals (2).
However, the patient as the central axis of the market access it is not limited to agreements between providers and payers. Currently, access models focused on prescribers as a target audience, where accessibility and acceptability barriers are reduced, have broadened their vision to include patients in decision-making through therapeutic information and self-care. as well as the final component of acceptability, adherence (3).
The informed patient, who has access to data and different content quickly through the internet, and who can decide whether to start or continue their treatment, is now a key player in market access strategies (see figure 1).
Figure 1. Information flow
How to focus strategies Market Access in patients?
There are several ways to focus access strategies on patients, some of them have already been mentioned, the PAS, based on innovation and price. However, there are other programs that have proven effective without necessarily including the additional negotiation or agreement of a price:
They are programs where patients receive information, are specifically oriented about their clinical condition, and develop skills for its management and can even help other patients with the same pathology, which must be chronic due to the time that is allocated to the correct training in this regard.
Through these programs “[…] It seeks to establish a connection between two or more people who have common characteristics, such as the presence of a disease, to favor the achievement of individual or group goals. Patients acquire an active and leading role, and health professionals a passive or observer role" (4).
These programs have been implemented for different pathologies in the United Kingdom, however, in Colombia so far only one provider has implemented them, although they are contemplated to be included in the Clinical Practice Guidelines (4).
They are telemedicine tools implemented through applications on mobile devices that help to remotely monitor the health status of patients, educate for self-care and guarantee adherence to treatments.
Many of these applications have been implemented to monitor patients with diabetes (5), HIV and, more recently, as a tool to identify and monitor mental health problems (6).
Prioritizing the use of scarce resources to generate the greatest gain in health, improve quality of life and reduce the numbers of mortality from all causes in the population are the purposes of health systems.