Programme overview
Introduction:
Pharmaceutical market access, covering pricing, reimbursement and payer negotiation, is a 5-day course for market access, pricing and government-affairs teams in medicines and medical technology companies that ends with a Market Access and Pricing Plan for a case product. Companies lose launch revenue when a product secures marketing authorisation but stalls at payer listing, faces reference price erosion across markets or signs rebate terms it cannot sustain. Nominees already prepare submissions or price proposals and work through case studies built on payer files, price corridors and contract terms. CoreConcept Training Center delivers this pharmaceutical market access course.
Course Objectives:
- Map payer archetypes, funding flows and access decision points for a medicine or device across public, insured and private channels
- Assemble a global value dossier and adapt its value story, evidence gaps and objection handlers to local payer submissions
- Set a launch price corridor using value-based, cost-plus and external reference pricing logic and plan launch sequencing to limit price spillover
- Prepare formulary listing files and public tender responses that meet payer evidence, price and supply requirements
- Structure managed entry and risk-sharing agreements, choosing between financial and outcome-based schemes and defining their monitoring data
- Negotiate list, net and confidential discount terms with payers and record the walk-away position and concession plan
Target Audience:
- Market access teams responsible for securing reimbursement and payer listing of medicines and medical devices
- Pricing teams responsible for launch prices, price corridors and net price governance across several markets
- Government-affairs and public policy teams responsible for engagement with ministries, insurers and purchasing bodies
- Health economics and outcomes research teams responsible for the evidence that supports payer submissions
- Tender and institutional business teams responsible for public procurement bids and contract renewals
- Country and regional commercial managers accountable for access targets and gross-to-net performance
Course Outline:
Day 1: Market Access Landscape and Payer Archetypes
- Payer Archetype Map of Single, Insurer and Out-of-Pocket Funding
- Access Decision Points From Marketing Authorisation to Patient Uptake
- Reimbursement Status Categories and Co-Payment Level Effects
- Stakeholder Influence Grid for Payers, Prescribers and Patient Groups
- Current Access Barrier Audit for an In-Market Product
Day 2: Value Dossiers and Pricing Methods
- Global Value Dossier Structure and Core Value Story
- Evidence Gap Analysis Using Real-World Data Sources
- Value-Based, Cost-Plus and Competitive Pricing Methods Compared
- External Reference Pricing Baskets, Median and Lowest-Price Rules
- Launch Sequencing Model to Contain Reference Price Spillover
Day 3: Reimbursement Submissions, Formulary Listing and Tenders
- Local Payer Submission Adaptation From the Global Value Dossier
- Budget Impact Summary Prepared for Payer Reviewers
- Formulary Listing File and Therapeutic Class Positioning
- Public Tender Bid Evaluation Criteria and Price Weighting
- Gross-to-Net Waterfall of Rebates, Discounts and Clawbacks
Day 4: Managed Entry Agreements, Negotiation and Access Risks
- Managed Entry Agreement Taxonomy of Financial and Outcome Schemes
- Price-Volume Caps, Free Initiation Doses and Expenditure Ceilings
- Outcome-Based Rebate Design With Patient Registry Data
- Payer Negotiation Planning With BATNA and Concession Ladder
- Parallel Trade, Price Cuts and Delisting Risk Responses
Day 5: Case Study: Market Access and Pricing Plan for a Case Product
- Case Product Payer Map and Access Barrier Review
- Case Price Corridor and Reference Basket Scenario Testing
- Case Managed Entry Offer and Monitoring Data Specification
- Payer Negotiation Role Exercise on Discount and Volume Terms
- Market Access and Pricing Plan Completion and Panel Defence
Skills You Will Gain:
- Payer Landscape Analysis
- Value Story Development
- Launch Price Corridor Setting
- Reference Pricing Impact Assessment
- Reimbursement Submission Writing
- Tender Bid Preparation
- Risk-Sharing Agreement Design
- Payer Negotiation Planning
Why Attend This Course:
- Deliver a Market Access and Pricing Plan for a case product to the general manager and the regional access director for approval
- Choose the launch price corridor, launch order of markets and type of managed entry offer with a documented rationale
- Avoid listing delays, reference price erosion and unsustainable rebate terms that cut net revenue after launch
- Equip access, pricing and tender colleagues with payer maps, dossier templates and negotiation planning sheets
Conclusion:
Back at work, the participant presents the Market Access and Pricing Plan to the general manager and the regional access director. Leadership uses it to approve the launch price corridor, the order of market entry, the reimbursement submission plan and the limits for managed entry offers and payer discounts. After the first payer decision or tender award under the plan, the organisation should compare the listing outcome, net price achieved and time to reimbursement with the plan and revise the weaker assumptions.
Frequently Asked Questions (FAQ):
What should participants know before a pharmaceutical market access course on pricing and reimbursement?
Participants should already work in market access, pricing, government affairs, health economics or tenders and understand how medicines or devices are registered and sold. An anonymised price list, payer file or tender document helps during the case study day.
How does pharmaceutical market access differ from a health technology assessment course?
This course is about the company side: payer mapping, value dossiers, launch prices, reference pricing, listing files, tenders, risk-sharing offers and negotiation. Health technology assessment courses concentrate on building and appraising cost-effectiveness models used by payers to judge value.
Why does external reference pricing matter for pharmaceutical market access and pricing?
A price agreed in one market is often copied into the price calculations of other markets. A low early price can therefore lower prices elsewhere, so launch order, price corridors and confidential discounts must be planned together.
What do participants take back from the pharmaceutical market access course?
Participants take back a Market Access and Pricing Plan for a case product, with a payer map, value story, price corridor, reference basket scenarios, a managed entry offer and a negotiation plan they can adapt to their own products.