We spoke with Gerhard Bothma, Senior Manager, HEMAR and Tender Management, EMEA, for LifeScan to discuss the need for market access to support business success.

What are your roles and responsibilities at LifeScan?

I am the Senior Manager for Market Access, Health Economics and Tender Management for EMEA, specifically focusing on SMBG. LifeScan forms part of the Johnson & Johnson Diabetes Care Companies, which focusses on both SMGB and Insulin Delivery.

Market access is about getting the right product listed for the right patient at the right price and at the right time to support business success. At a Regional level our responsibility is to track these elements to understand if delays happen, why those delays are being caused and then what we can do as a team to try to overcome those delays. Additionally, we support the countries in achieving their access targets by tracking those targets against expressed targets, understanding and communicating successes as well as reasons for delays. Under market access, we also have the responsibility to develop capabilities. These would be market access or strategic affairs capabilities required by functional optimally within the Market Access function, but also capabilities that the new sales organization potentially would require, like evidence-based selling and value communications.

Under health economics we are responsible for the development of value communications that are both clinical and economic in nature. We develop what we call “value conversation guides”. Whilst developing these Value Communications, we often also identify healthcare resource utilization evidence gaps. Our responsibility is then to communicate these to our Global Counterparts with the aim of finding ways to fill these gaps.

Lastly, under tender management, I am the chairman of the European Tender Leadership Team of LifeScan, and it’s my team`s responsibility to drive what we call the ‘Tender Excellence Approach’ into EMEA and specifically the tender markets of EMEA. This ‘Tender Excellence Approach’ has three different pillars: strategy, resources and execution. My team supply tools, resources and define governance for these three pillars.

At the end of the day, however, the European Tender Leadership Team is accountable for winning tenders.

For how long have you been with Johnson & Johnson and LifeScan?

I’ve been with Johnson & Johnson for 13 years, in market access since October 2006 and at LifeScan since September 2014. I was responsible for market access at a country level, specifically South Africa, and then at a regional level when I was working and living in Dubai for the Middle East, Egypt, Turkey and Pakistan and now at the EMEA level since September 2014.

Can you describe how you are supporting the company to gain market access?

In a nutshell it’s really about defining the strategy, driving the implementation of that strategy, tracking the success of the strategy and communicating that success to the broader organization.

If we start at the top, firstly we support in defining and crystalizing the market access strategy in terms of target portfolio positioning, target patients and target price and then also in terms of target customers. Once the strategy has been stated, our job is also to make sure the countries comply to that strategy, within the context of the local environment and local business objectives.

Then, it is also very important to prioritize your support. You can imagine, in a region like EMEA, you cannot necessarily serve every market to the same level. We look at the launch schedule of a new product, as well as the priority of that market, and then, in consultation with that market, understand what their ‘go-for-access’ plans are, how are they going to implement, how are they going to track success and what they are going to require from the EMEA office to implement their ‘go-for-access’ plan. This requires working with those countries very closely.

Once we see gaps in the plan or the resource requirements to execute the plan, we need to lobby with the global office and other stakeholders to try and fill those gaps. Those gaps could be evidence gaps that very often take a little bit longer to fill, but it could also be value communication gaps or gaps in terms of price approvals. Most companies have floor prices, and we have a process where, if your market access strategy requires you to go below the floor price, then you need to apply for a price exemption.

For the target markets, we track the success of access within the strategy and also raise awareness about the success. We report to the European Leadership Team some of the successes that are being obtained in these markets, and we also form part of various other committees to inform these committees and working groups on the progress of access.

Also, there are always non-focus markets that require attention on an ad hoc basis. We need to be flexible enough to support that.

On a day-to-day basis what are the challenges you face with regards to Market Access?

In my opinion, there are both internal and external challenges. Internally we are always faced with this question about what is the value to the business. We are challenged by senior leadership when asked, “This is all nice, it sounds great, but how are you contributing towards achieving our business targets?” So internally the challenge is always to not just quantify the impact of market access, but to also clearly communicate in a language that is understood by the commercial leaders or the business leader(s) of the organization.

We are lucky at LifeScan in that, due to the vision of our senior director, we have quite a strong infrastructure. We have an EMEA-based office, but then we also have market access leaders and teams for each of the countries, to a varying degree. That really makes it possible to have and achieve targets in line with your portfolio and pricing strategy.

Furthermore, it remains a continuous challenge to maintain the internal validity of market access. On the one hand this means making sure that you achieve your expected targets. On the other hand, it means that you make sure you are communicating in a language that the business understands.

Externally, market access is becoming more complex. If you think about Europe, Middle East and Africa (EMEA), you get a wide variety of market access requirements. In some countries what you really need is a CE mark and that gives you freedom to promote in that country. In other countries, like the UK for example, market access is a multi-tier process that can take a few years to achieve in full.

Every year there are more and more layers that are being added to the mix. Obviously the more layers that are added, the longer it takes to get to market, the shorter your time in the market. And the shorter your time in the market, the less potential revenue you get. Keep in mind that Market access can be viewed as a cost center.

The other challenge that we are seeing is that the requirement for evidence is becoming more and more important. In pharma evidence is relatively available in abundance by the time they go to market. As we know from medical devices and specifically, in-vitro diagnostics, at the time we want to go to market, our evidence is often very limited, and it’s often just enough to align with registration or regulatory requirements.

Lastly, and at least certainly in the business that we working in, there is an ever-increasing trend towards commoditization. That makes access different, because it puts a very big pressure on the price of access and a big part of the strategy that we have to employ in our business is to protect price whilst getting access. That has really become a very key focus.