How local implementation strategies and payer engagement quality can influence time to access, breadth of access, and price – and what pharmaceutical companies can do about it.
A successful market access launch is typically measured against three KPIs: time to access, breadth of access, and price. But these metrics only tell part of the story. The hidden drivers – payer perception, engagement quality, and message recall – can directly influence whether those KPIs are ever met. Without a structured feedback loop to capture these softer signals, country teams are left making tactical decisions in the dark.
The traditional access triangle: necessary but not sufficient
When a pharmaceutical company launches a new product or indication, global teams set a market access strategy anchored in a familiar framework: the Access Triangle. Regional and local teams are then responsible for translating that global strategy into tactical, actionable implementation plans.
The three KPIs are:
- Time to access – how quickly is reimbursement achieved?
- Breadth of access – which patients or geographies are covered?
- Price – was the manufacturer’s target price achieved or maintained
The outcome of these KPIs is black and white – they are either met or not met. If they are met, everyone is happy. If not, there is rarely a structured feedback loop to help country teams understand the subjective drivers behind that shortfall. In most cases, at least one of those three KPIs will require some degree of compromise – but without understanding why, the same mistakes are repeated.
The hidden obstacles influencing market access outcomes
Beyond clinical evidence and value dossiers, there are more subtle, psychological and relational factors at play. These include:
- Payer perceptions of the manufacturer – a single negative engagement in the past, or a perception of low trustworthiness, can unconsciously colour reimbursement decisions.
- Frequency and quality of payer communications – too frequent, and payers feel overwhelmed; too infrequent, and the manufacturer risks being forgotten.
- Channel appropriateness – a cold call to a busy hospital pharmacist may be disruptive and counterproductive. The right message in the wrong channel can undermine an otherwise strong engagement strategy.
- Message recall and competitor benchmarking – if payers cannot recall your product’s key value messages but can recall a competitor’s, your product is not top of mind when reimbursement decisions are made.
- Corporate reputation and portfolio perception – do payers view your company as trustworthy? Do they consider your portfolio worthwhile? These broader perceptions feed indirectly into how individual products are received.
How market access teams currently engage with payers
Most access teams today use some form of omni-channel engagement. The most common channels are:
- Face-to-face meetings – still preferred in many markets and cultural contexts, particularly for high-stakes conversations.
- Phone calls – useful for follow-up and relationship maintenance, though timing and context matter.
- Email – often the preferred first point of contact, particularly for stakeholders with busy clinical schedules.
- Digital and indirect channels – including LinkedIn, targeted advertising, and webinars, which are growing in relevance post-pandemic.
The mix of channels used, and how they are sequenced, can significantly affect the quality of the payer relationship. Yet most companies do not systematically measure whether their chosen engagement approach is actually working.
Why the current feedback loop is not enough
There is a traditional feedback loop in market access: value message testing, health technology assessment outcomes, and reimbursement decisions. These are valuable, but they are lagging indicators. They tell you what happened – not why, and not what you could do differently.
What is largely missing is a structured mechanism to capture:
- How payers perceive the manufacturer as a partner, not just a supplier
- Whether communications are seen as relevant, timely, and trustworthy
- How the company’s engagement compares to that of competitors
- Whether payers can recall the brand’s key value messages
Without this insight, country teams are left making tactical decisions in the dark – unable to course-correct before a reimbursement outcome crystallises.
How to start measuring payer perception: a practical approach
The most effective way to build this missing feedback loop is through impartial, structured primary research – commissioned from a third party to ensure objectivity.
Step 1:
Define what you want
to measure
- Corporate perception: trustworthiness, social responsibility, portfolio value
- Engagement quality: frequency, relevance, channel appropriateness
- Message recall: can payers name your product’s key value claims unprompted?
- Competitive benchmarking: how do you compare to other manufacturers?
Step 2:
Select the right research methodology
- Qualitative interviews with payer decision-makers to uncover nuanced perceptions
- Quantitative surveys to benchmark performance across markets and against competitors
- Advisory boards facilitated by a neutral third party to capture candid feedback
Step 3:
Analyse findings against KPI performance
- Overlay perception data with access outcomes by country or region
- Identify correlations between low payer trust scores and delays in time to access
- Use findings to prioritise where engagement strategy changes will have the biggest impact
Step 4:
Connect insights to tools
like Access Hub
- Platforms like Access Hub already track reimbursement status and price across markets
- Combining this with perception data creates a richer picture of what is driving outcomes – not just what the outcomes are
- This enables global teams to learn from high-performing countries and support those that are struggling
Hear from the experts at Access Infinity
Listen to the Market Access Matters podcast with Megan O’Brien, Associate Director at Access Infinity, to hear more about how payer perception shapes market access outcomes – and what teams can do about it.
Frequently Asked Questions
Payer perception refers to how healthcare payers – such as national reimbursement bodies, hospital formulary committees, or regional health authorities – view a pharmaceutical manufacturer and its products. Perception influences trust, which in turn shapes how receptive payers are to value messages and reimbursement submissions. A negative perception, even from a single poor engagement experience, can unconsciously bias decision-making.
Value message testing evaluates whether specific clinical or economic claims land as intended – are they clear, credible, and relevant? Payer perception research goes further, examining the broader relationship between the manufacturer and the payer: trust, engagement quality, communication frequency, channel preference, and competitive standing. Both are important, but most companies do the former without ever doing the latter.
Ideally, perception research should be conducted at key milestones: before a launch to establish a baseline, at the time of HTA submission, and post-launch to identify areas for improvement. In competitive therapy areas, annual (or more frequent) benchmarking may be appropriate to track shifts over time.
Yes, and this is one of the key benefits. Global and regional teams can use perception data to identify which countries have the strongest payer relationships and what they are doing differently – then share those best practices with markets that are underperforming. Connecting this data to a tool like Access Hub makes it even more actionable.
Conclusion
Meeting the Access Triangle KPIs remains the ultimate measure of market access success. But relying solely on black-and-white outcomes – without understanding the subjective drivers behind them – leaves teams without the insight they need to improve. By building a structured feedback loop around payer perception, engagement quality, and message recollection, pharmaceutical companies can provide local teams with the tools to engage more effectively, communicate more memorably, and ultimately achieve better reimbursement outcomes.
Want to find out how your payer engagement strategy measures up?
At Access Infinity, we help pharma companies understand the hidden drivers behind their market access outcomes, from payer perception research to actionable engagement strategies.
Get in touch with our team here to discuss your specific needs.
About the author
Megan is an Associate Director at Access Infinity with nearly 15 years of pharmaceutical consultancy experience, specialising in pricing and market access, real-world evidence generation, and business intelligence. She has led strategic partnerships for major pharmaceutical clients and offers deep expertise into the world of payers and market access strategy across global markets. Megan has also designed and delivered single- and multi-sponsor non-interventional RWE studies, delivering pragmatic, evidence-based solutions to address complex market access challenges designed to meet the needs of payers.
If you have a question or a project in mind, get in touch with Megan by emailing megan@accessinfinity.com or via our contact us page.
