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.