8 Proven Strategies to Improve Market Access With Closed Claims Data

Imagine investing a staggering $2 billion¹ to bring a groundbreaking drug to market, only to see it fail to meet expectations - a fate that befalls over 36% of new drug launches in the U.S.¹

In today's fiercely competitive pharmaceutical market, effective market access strategies are essential. The difference between success and failure often hinges on the data driving your decisions.

That's where closed claims data provides a unique advantage. By offering validated, longitudinal insights, closed claims data empowers you to secure formulary placements, optimize pricing strategies, and strengthen payer negotiations.

In this blog, we reveal eight proven strategies to solve for common challenges in the pharmaceutical industry by leveraging closed claims data effectively to improve patient access and propel your market access strategy to success.

1. Challenge: Fragmented data obscures the patient journey

Patients with chronic conditions typically experience 6 to 10 different healthcare touchpoints in a year,² and must navigate a labyrinth of treatments and services. Relying on incomplete or siloed data means you're missing crucial insights, leading to ineffective strategies and missed opportunities.

Solution: Gain comprehensive market insights with closed claims data

Closed claims data offers a holistic population health view, enabling a comprehensive understanding of longitudinal patient journeys. By accessing validated, end-to-end insights, you can drive better market analysis, develop more effective interventions, and ultimately improve patient outcomes and market performance.

2. Challenge: Standing out in a crowded market

In an industry saturated with options, your product is at risk of blending in the crowd. Without clear differentiation, payers and providers may overlook your offering, jeopardizing formulary placements.

Solution: Develop differentiated value propositions using closed claims data

Utilize validated outcomes data from closed claims to craft unique brand strategies that highlight the distinctive benefits of your products. By uncovering specific therapeutic advantages, you can create value propositions that truly resonate with payers and organized providers, increasing the likelihood of successful formulary placements.

3. Challenge: Weak partnerships limit market research

Without reliable evidence of treatment value, building meaningful partnerships with payers and organized providers is an uphill battle. This disconnect impedes targeted initiatives and compromises patient engagement.

Solution: Foster strong collaborations with closed claims data

Closed claims data provides a comprehensive view across the entire care continuum, including inpatient, outpatient, emergency room, and pharmacy interactions. This holistic perspective allows you to offer reliable evidence of treatment value, facilitating stronger collaborations. Develop targeted campaigns that address care gaps and enhance patient engagement, amplifying your market access strategy.

4. Challenge: Ineffective targeting wastes valuable resources

Generic engagement strategies fail to address the diverse needs of different patient populations. Without precise segmentation, you're squandering resources and missing opportunities to improve patient access.

Solution: Implement precise population segmentation with closed claims data

Having access to closed claims data makes it possible to target segmented portions of the population and improve engagement strategies. By identifying treatment gaps and analyzing demographic and socioeconomic characteristics, you can tailor your engagement efforts to better meet diverse patient needs. This precise segmentation supports customized outreach programs, ultimately improving market access strategies and patient support.

5. Challenge: Limited real-world evidence weakens payer negotiations

Without comprehensive data from actual clinical settings, demonstrating your product's value becomes a tough sell. This lack of real-world evidence can undermine your position in payer negotiations and hinder market success.

Solution: Strengthen RWE efforts with closed claims data

Closed claims data bolsters real-world evidence (RWE) initiatives, particularly in health economics and outcomes research (HEOR) studies. This robust data foundation allows you to showcase your product's value in real-world settings, enhancing credibility and driving payer acceptance in your commercial strategies.

6. Challenge: Misguided pricing strategies erode revenue and market share

Inadequate financial insights can lead to pricing decisions that don't align with payer needs or patient experiences. This misalignment results in poor reimbursement processes and lost revenue.

Solution: Optimize pricing strategies using closed claims data

Leverage the detailed financial insights from closed claims data to support strategic pricing and contracting decisions. By understanding the full financial impact across the care continuum, you can refine your pricing strategies to align with real-world experiences. This approach can inform initial pricing decisions and ensure successful pull-through going forward.

7. Challenge: Rapid regulatory changes require swift adaptation

Regulatory landscapes shift quickly, and relying on outdated or incomplete data hampers your ability to adapt. This lag can compromise compliance and data integrity.

Solution: Maintain quality and compliance with closed claims data

Stay compliant and uphold high standards of quality by leveraging the accurate, longitudinal insights provided by closed claims data. With the ability to run real-time algorithms, you can adapt swiftly to regulatory changes, ensuring data integrity and process reliability beyond what published CMS data can offer.

8. Challenge: Short-term interactions fail to build lasting relationships

Sustained market access success relies on strong, long-term relationships with payers and organized providers. Without ongoing collaboration, your strategies may not meet the evolving needs of key stakeholders.

Solution: Build long-term relationships using closed claims data

Closed claims data enhances collaboration with payers and healthcare providers by providing a detailed view of patient outcomes and treatment efficacy. This transparency allows market access teams to share real-world evidence, maintaining open communication about product performance. Continuous data flow supports payer endorsement and patient access to treatments, helping companies build lasting partnerships with key stakeholders through demonstrated product value.

Drive market access success with data-driven strategies

Don't let fragmented data and ineffective strategies hold you back. Closed claims data empowers market access teams to enhance formulary access, improve payer negotiations, and achieve substantial financial gains.

The comprehensive, validated insights provided by closed claims data are critical for developing effective market access strategies that drive long-term success.

Are you ready to craft a successful market access strategy and outperform the competition? Embrace these approaches and unlock the full potential of closed claims data to make a meaningful impact on patient lives and your bottom line. See the solution in action with a personalized demo of Provider Market Insights.

Learn more about the advantages of closed claims data for commercial strategy by reading the next blog in our three-part series.

1. "Rethinking market access," Brian Corvino, John Jaeger, Natasha Elsner, Madhushree Wagh, Deloitte Insights, accessed October 2024, https://www2.deloitte.com/us/en/insights/industry/life-sciences/pharmaceutical-market-access.html
2. "The never-ending patient journey of chronically ill patients: A qualitative case study on touchpoints in relation to patient-centered care," Vera Maas, Frederik Dibbets, Vincent Peters, Bert Meijboom, Danielle van Bijnen, PLoS One, May 17, 2023, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285872

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