No Shift, Sherlock: Share Shift Analytics and Best Practices
No Shift (Know Shift), Sherlock. Understanding share shifts is the most critical aspect of payer contracting. Contracting analytics have evolved over the past five years, however, too many manufacturers still base contracting decisions on historical one-offs, a catalogue of dated analogues, or loose assumptions. HaydenCG has compiled our top punch list of share shift analytic practices for your 2022 deal modelling & payer negotiations:
1. Don’t benchmark access losses (or wins) to singular examples
When GSK’s asthma medication Advair lost coverage on Express Script’s 2014 formulary, it was the gasp heard ‘round the pharma cafeterias (Figure 1). Advair’s share fell, and by April GSK and ESI announced that coverage would be restored by 2015. Institutional memory is, and should be, an important element of a brand’s long-term planning & contracting strategy. Often, cataloging historical negotiation tactics and account-specific priorities can lead to future access wins. However, contracts should not be benchmarked to a single event. Ultimately, the same restriction can have different effects, as payers demonstrate variability in managing their own formularies. Additionally, other market dynamics like the size of the continuing patient population or regional prescriber demand will determine the net impact of an access shift.
Figure 1: Express Scripts Preferred Drug List 2014
2. Use relative share changes to predict a contract’s impact, versus an absolute share expectation
“Unrestricted access gets us 30% share” might apply for your accounts that never lost access. But using absolute exit share to describe a formulary position intrinsically assumes that:
All disadvantaged accounts perform exactly the same (they don’t!)
Share losses due to disadvantaged access can be attributed entirely to restrictions or utilization management criteria (versus other market dynamics, including a loss in physician demand or competitive threats)
Relative share shift curves take into consideration a brand’s account-specific performance, while holding manufacturers accountable to pull through & capitalize off their improved positioning.
3. Unlocking access on paper is only the first step – access wins must be complemented with growing or capitalizing off demand
All wins are not equal. Since every prescriber sees patients with many different payers, a critical threshold exists for “having access” vs. just “having a contract”. You need your customers to believe your brand has access. Having enough access to make this believable means building from the bottom-up; stacking enough wins to surpass that critical threshold. HaydenCG’s recommended approach (Figure 2) starts at the individual contract decision-point and builds a layered picture of expected and not realized revenue based on access.
Figure 2: Overview of HaydenCG Approach & Methodology
Special thanks for Katie Harris for her work on this blog.
Hayden Consulting Group
HaydenCG is the life sciences industry's premier Market Access and Commercialization strategic consultancy. Our focus is to deliver game-changing strategic guidance and analytical vision to transform the commercial trajectory of therapies, portfolios, and entire companies. Our services are designed to create competitive advantages, establish strong analytical foundations, build growth plans, and address Life Science industry's most pressing Access, Reimbursement, Policy, and Commercialization challenges. Follow us on LinkedIn.