Patient Access positions with Baxalta

Dear Readers,

I am currently building my access team in EMEA and have a few positions open. I am looking for a patient access lead oncology Switzerland/Austria. See job posting: https://lnkd.in/d3MyQgQ 

Equally I am looking for patient access heads for Italy and the UK. Oncology experience plus experience with local P&R submissions and negotiations is required.

If you are interested please get in touch: ulf.staginnus@baxalta.com



England NHS cancer drug fund to be handed over to NICE?

Dear All,

Some interesting developments on the Cancer Drug Fund have been announced today.



Market Access in Germany and AMNOG reform needs

Dear All,

hope you are getting ready for the summer.. just came across an interesting post on the GKV Spitzenverband website. A latest study from the Technical University of Berlin demonstrates the fastest (even after AMNOG) and broadest access to medicines occurs in Germany as compared to other EU countries (well, it´s nothing really new). This comes at a "cost" with highest pharmaceutical prices being paid in Germany (we also knew that). The study has a lot of good sources such as the times to access after EMA approval (many of you in the industry get this question all the time from management), approaches to pricing in the different EU countries as well as the reference baskets etc...

The interesting part comes further down in the GKV press release. Prof Busse (check out his slides) suggests that pricing is related to the benefit provided in each subgroup. Something economists welcome as it it would allow for differential and indication specific pricing better linking value achieved to pricing potential. The pessimists would obviously say that it further increases pressure but in my view that would be the right direction and for really innovative and beak through therapies provides opportunity.

Reform needs are seen with AMNOG, measures such as retrospective rebates are suggested in the presentation from v. Stackelberg (GKV SV) from month 7 onwards of the benefit assessment process. He makes a fair statement in saying with "retrospective price setting premium pricing is still possible for top products, but no excessive pricing for drugs without additional benefit".

Let's see what is cooking out in Germany. Happy Summer Holidays ;)


The value discussion

Dear All,

first of all apologies for the quite time lately, been busy with various projects. Seeing the article from Ed it reminded me of the ever ongoing discussion about the value topic and if agreement can be found between payers and industry. Certain attempts, thinking here of VBP in the UK have failed and others have not taken off. Ed does a good job in listing the issues and especially pointing out the ways the industry could change things internally. This is definitely true and also a very old story. I have a bit of my own theory why things are so slow to catch on internally. Everyone is talking the market access talk and adds resources and re-invents departments etc. What I see happening though is that the wrong people with the wrong skill set are often doing this. Just because it seems to be hip to talk about payers and access and engagement doesn't necessarily mean the skills are there. Too many of certain "talkers" who are used to making colorful slides are digging around the access area, which however doesn't make them an expert just as yet. Health economics and especially pricing and skills around data creation and epidemiology are typically missing. Also lack of experience with the various health care and reimbursement systems and how things are working often leads to the wrong expectations. I couldn't agree more with Ed's comments that functional organizations, usually the experts from health economics/pricing and access, get the issues quickly but often have limited influence to the top and on R&D decision making as there still too often the old fashioned "slide makers" and "talkers" are sitting. The 'species' of real good access people often doesn't bother to engage on this "less scientific" level of discussions hence nothing ever changes. The only way to change that would be if jobs are re-defined and key roles are being filled with people who have exactly that payer perspective and experience - and they don't need to have been in sales to do a fine job there. That is a relict from a time that doesn't exist and wont come back anymore.



Potential "Pay if you clear" access scheme in Scotland

Dear All,

just saw this on BBC

Now if that scheme materializes it truly deserves to be called an innovative one ..



Jobs and interviewing in Market Access, Health Economics and Pricing

Dear All,

a little post from the beach, I trust most of the readers enjoying their well deserved summer vacation. By popular demand in the past when I conducted and published my salary review, and actually due to a lot of personal experience, I am finally getting around on writing a little about the topic of interviews and job search. Most positions in our field are recruited by headhunters or company talent scouts but also network and other ads, e.g. on pages like healtheconomics.com and healtheconomics.org are important information for job seekers. Networking through linkedin.com has also proven very valuable for many of my colleagues and fiends. But nothing beats a personal recommendation or contact that puts you in touch with a potential employer. Therefore in identifying positions you should not find it too difficult as this market is rather transparent and demand for health economists, market access and pricing as well as health policy people seems to be still steadily increasing.

What is interesting is how different companies conduct their interviews. I must say I came across the whole spectrum from very professionally conducted and fast processes to total odd behavior. One day for example I went to an interview for a position of EU market access head with a specialty pharma company and flew about 8 hours in one day taking 4 flights, and changed an important family event travel in order to get to a city in Eastern Europe where they were at a conference. Finding the meeting room the head of Europe of this firm shows up, and with very little introduction and barely a 'hello' and combined with a rather odd and impatient behavior asked me about an old story that he had encountered years back in one EU country where a drug was supposed to be introduced into the market and they had some package insert issue of a cardiovascular agent that the agency apparently had been misplaced etc. etc... now wanting to know what I would have done... I was a bit puzzled about the wired case and answered that this was a regulatory matter usually not in my shop but as in any interaction with authorities would have gone back to them with another copy of the package insert and asking them politely to reconsider and approving  bla bla bla.. that was apparently not a very satisfying answer and even more impatient now the guy rambled on about how this would have delayed his launch in the country as the agency would have found another excuses and bla bla bla.. now me getting tired I simply said (so smartass I thought to myself) what did you finally do? ..well he said he put the updated package insert and launched without approval of the regulatory agency and than creating some political pressure and bla bla bla.. as you can guess by now we are talking about a Southern European country here with lovely pasta tough... anyhow, I just responded dry, coming from a couple of companies that take compliance as a serious value, that is an answer he couldn't have expected to receive from me... anyway the talk didn't get better, we went through a few more odd cases alike and the second guy that showed up thereafter, equally arrogant, didn't really improve my day.

A few days later they (I had advanced already another process with a biotech that professionally quick conducted two interviews in one day, plus a few on Skype the day thereafter) wasted more time by having had the headhunter call one of my references etc.. just to tell me two weeks later, via the recruiter, they were still deliberating and thinking and needed to ask more references about my strategic abilities... probably due to my answers on the package insert discussion beforehand ;)

That's when I decided I had enough of this BS and emailed the headhunter to call it a day with this process, which I should have probably done right after the second round 8 hour trip... after all in my career I had launched more than 4 major products in Europe each of them largely exceeding their one or two product portfolio and therefore concluded to myself that I had no desire no need for additional nonsense from this company. I was wondering anyway what they really wanted here.. it seemed like they were selling a glorified "head" as sort of an assistant to the two guys probably wanting to get rid of stuff they didn't wanted to do anymore... outside voices later on confirmed my sensation about a wired climate there...

But why am I telling you all this, what's the morale of the story here. Well, know your worth and live it! Don't sell yourself too cheap or too fast nor let yourself in strange situation be diverted from what your true experience but moreover your values are. Don't settle for any compromise that doesn't feel right even if you may get impatient with your job search. And remembering Steve job's famous words from a Stanford graduation, don't let your inner voice be drowned by other peoples opinion, don't settle if it doesn't feel right, keep looking, stay hungry, stay foolish ;) !!! and listen to your gut feeling...

And here my personal checklist:

- do your background research very well, ask around, this is a small world, you quickly would find out why a role is vacant too often or takes too long too fill.. there might be personality issues at this company
- ask about the real responsibilities, who decides what, what can you do, are you going to be part of negotiations/authority contacts etc? Who decides your travel, can you attend certain professional meetings/conferences? What budget does the role have, reporting lines etc as titles often are inflated or mean little. From a certain level onwards you don't want to sit around in the headquarter talking about the payer needs but actually never seeing the payer
- be wary of two many rounds and hick hack, the best jobs and match in my experience are those where the process is closed from first call to signature in 4-6 weeks max. Imagine if the process is a major pain, what will the work environment be like ???
- don't become a quotation filler, in other words feel when you are being put forward just to fill the candidate pipeline, don't waste your time with silly presentations unless you need interview practice
- be open and transparent about your situation, financials and expectations but also request the same
- people who don't hold their word... will call you back by Friday, and don't.. drop them, no worth considering, they will continue like this
- you get an offer with the one you like, they have been quick, honest, with professional style and ethics - take it quickly and don't be too fussy about unimportant things, negotiate the big items important to you, if the salary is great and you get stock  .. don't patronize about canteen vouchers for example ;) .. you are laughing, I have seen it...
- and I repeat it, trust your gut, if something doesn't feel right it will be most likely not be good in the end
- remember for skilled people with experience this is a buyers market, far more demand than qualified people, get the right job for you and wait if the first one that comes along casts any doubts

Cheers to all readers, happy summer holidays!


Guidelines for payment by results in Catalunya

Dear All,

CatSalut has published a first version of guidelines for the implementation of payment by results schemes for pharmaceuticals.




No linear association between drug prices and perceived benefit criticises US cancer expert...

Dear all,

pricing of cancer drugs and now also hepatitis C has steered another debate among US payers and physicians about drug prices. See a recent article in business week.



Germany becoming the "wild card" in drug pricing

Dear Readers,

just saw this in the news (see link below). Germany is thinking of issuing a new law that the so far confidential price discounts be made public. That would be an entire new ballgame for the industry in Europe with potentially significant price erosions and spillover effects elsewhere.

Will keep an eye on that.




Critique on lower NICE threshold research

Hi everyone,

sitting here on my desk with a typical December cold, I came across this critique from the OHE of something that gives me even more headaches when reading it. I can't resist giving my 5 cents to it. Seems like Claxton and colleagues have proposed a new NICE threshold of £12,936 ... wooooow and how accurate! I am amazed how politely and scientific the OHE responded to that. My critique is much simpler and less kind: total rubbish!
With all respect for the academic credentials and experience of this group, but this tells me that someone has not understood the bigger things in life that are far more complex than putting forward such a silly paper (and number). I recommend reading a bit of Friedrich August von Hayek's key papers: "The pretence of knowledge" and "The theory of complex phenomena" before engaging in another round of "scientific" threshold analysis: Medicine is not physics, decision making about factors that affect health, physical well being and perceived quality of life etc. do not fit, and should not be decided based on, a foolish formula, full stop.

A good evening to everyone


UK VBP - paddling back big time ?

Dear All,

it took some time for the UK government to come out with something on the VBP debate. Now the first details of the new "deal" emerged. What is now on the table looks quite different from what was set out as an objective, but not at all from what has been done so far. Of course we are not surprised knowing all along how difficult it is to implement something that sounds easy in theory. Pretty much everything stays the same, the threshold, NICE doesn't have a role in price setting apart from some wider  benefits to the society are now supposed to be included in the assessment of new drugs.

Below a bit of reading on the topic.




Survival and spending on cancer care in the EU

Dear All,

a new study has been presented at ESMO in Amsterdam. Researchers presented data on cancer spending in relation to overall mortality across the European Region. Not surprisingly confirming the relation between poor investments in cancer care and overall outcomes.



"No hour" week...

Hi All,

today a post a little off our topic here but most important. Patti from healtheconomics.com posted this link, which I find very interesting. Its about flexibility in your daily working considering our times of modern technology and connectivity. It just hit it right on the head, I remember working in big corporate headquarters occasionally sitting around in endless meetings where some of them appeared to be dictated to beating time or because they were in some sort of agenda or somebodies annual objectives... there is only so much to say in endless weekly market access meetings when your product is still 3 years away, is there..?

So this article was refreshing, indeed within pharma we need a mindset like that, treat people like adults and work on the important stuff with focus, passion and dedication and cut out the dead wood. Go for a round of mountain bike to start the day and do something right later in the office rather than pester people around the globe with the x update of the update at 7 a clock in the morning.

The other topic is remote working, motivated and dedicated workers will perform well weather they sit an office or on their terrace at home - at this level childish control is counterproductive. Yet I was surprised to hear when Yahoo's new CEO decided to ban remote working. Most ridiculous, at least in my view, was the argument that best ideas and solution come from the talks in the floor around the coffee machine. A phrase that is totally overused and as I believe also fundamentally wrong. What people do at such encounters is engage in latest company gossip.. Best ideas come from motivated, happy, engaged and well rewarded employees that can identify themselves with their company and products and are treated in a way that allow them to flourish professionally, shift their work around their style, e.g. no use to force a night owl at 7am in the office etc..

I like and already live that concept and, yes, it does work very well but so far mostly in smaller companies although a very few of the bigger ones are already further ahead as well.

Have a nice day


VBP event September 24-26 London

Dear All,

VBP in the UK is around the corner and Hanson Wade (see post below) have invited Olivier and myself to run a pre-conference workshop on VBP. Looking forward to seeing many of you!

Best wishes

At Value Based Pricing (24 - 26 September, London) authors of The Future of Health Economics, Ulf Staginnus and Olivier Ethgen will be leading an introductory workshop to get you up to speed on the considerations and implications surrounding value-based pricing. This interactive session will enable you to practically implement value-based strategies into your drug development programmes and ensure you meet the growing demands of payers around Europe.

Attend their interactive half-day workshop to:
  • Explore what a VBP structure will mean for the UK - get to grips with the changing pricing structure and understand how it relates to other EU countries
  • Evaluate the practicalities of incorporating VBP into your strategies and realise what is achievable for your portfolios
  • Understand how value can be defined and whether it should be consistent across disease indications and patient populations
  • Discuss international reference pricing in relation to value-based pricing

Download the brochure to see the full Value Based Pricing agenda and information on the other 2 workshops. 

Following on from the workshop day, Value Based Pricing will feature companies working across Germany, France, Switzerland, The Netherlands, Belgium and the UK openly sharing their experiences of developing value-based pricing strategies, preparing you for the impending pricing changes in the UK. 

This meeting represents your greatest chance to be as prepared as possible for a value based pricing system in the UK and across Europe. Join your peers at Bayer, Vifor Pharma, Novartis, Ipsen Pharma, InterMune, GSK, Merck Serono, Takeda, Bristol-Myers Squibb, Pfizer and Amgen among others.

Register before Friday 28th June to save up to £300 off standard rates. To secure your place, visit: www.valuebased-pricing.com/register 

Best wishes,

Emma Hosgood
Programme Director
Hanson Wade


Oncologists critizise cancer drug pricing in the US

Dear All,

a recent paper in Blood sharply criticizes the pharmaceutical industry for the prices of cancer (CML) drugs. I am a little surprised that they have started to hinge the debate so much on Gleevec maker Novartis Oncology. Among all the newer cancer drugs that is certainly not at all an example of over pricing, considering the tremendous benefits that this drug has brought to CML patients. Its pricing, especially compared to other cancer drugs nowadays was actually rather modest. In addition, in Europe (already in some markets) and the US it is available off patent soon. (Net) Price increases have certainly not happened in Europe and the cited US increase surprises me as well as we know net pricing is a different story. Anyhow, they do have a point however on other occasions and it is therefore important to move away from the price per pill concept and discuss and establish innovative pricing models that meet the interest of all stakeholders involved, especially those that are linking the financials closer to the actual benefits delivered over time.