What does Market Access actually do?

[anonymous]

I feel like every quarter coverage gets worse. I’m not even excited to get commercial scripts anymore because they’ll probably require a PA and get denied or cost an arm and a leg. I get Medicare and Medicaid are always going to be tough but this drug has been out long enough that commercial scripts should be a lock.

 

[anonymous]

I feel like every quarter coverage gets worse. I’m not even excited to get commercial scripts anymore because they’ll probably require a PA and get denied or cost an arm and a leg. I get Medicare and Medicaid are always going to be tough but this drug has been out long enough that commercial scripts should be a lock.

That’s the thing. Commercial should be a lock, but it’s not. Nothing is a sure thing here. Uncertainties have devastated morale and continue to result in people leaving this dumpster fire.

 

[anonymous]

It is worse. I don't know why, but the coverage has gone downhill.

 

[anonymous]

It is worse. I don't know why, but the coverage has gone downhill.

Obviously senior leadership doesn’t care. They are making their money somewhere. This company is a train wreck.

 

[anonymous]

In their defense managed care really does not cover old duds and reformulations.

 

[anonymous]

Market access: just tell them to put the script in and see what happens lol

 

[anonymous]

Market access: just tell them to put the script in and see what happens lol

“All of these plans have unrestricted access!”

Co pay = $2000

Yeah thanks that doesn’t help

 

[anonymous]

In their defense managed care really does not cover old duds and reformulations.

In my area the commercial covered it without a lot of push back or deductibles. That has changed.

 

[anonymous]

In my area the commercial covered it without a lot of push back or deductibles. That has changed.

So what's changed? Hearing this from a lot of people.

 

[anonymous]

So what's changed? Hearing this from a lot of people.

BCBS is terrible now. Other commercial plans require PAs now when they didn’t used to. High copays even after the copay card is applied.

 

[anonymous]

BCBS is terrible now. Other commercial plans require PAs now when they didn’t used to. High copays even after the copay card is applied.

Senior management doesn’t want to discount the drug to payers. They rather get more from less so to speak. But that isn’t going to help you in the long run. Very few areas are in a good situation. Everyone else will be sunk in the mud with no other options.

 

[anonymous]

Senior management doesn’t want to discount the drug to payers. They rather get more from less so to speak. But that isn’t going to help you in the long run. Very few areas are in a good situation. Everyone else will be sunk in the mud with no other options.

Then that takes the conversation back to the original question. What does Market Access actually do?

 

[anonymous]

In general, Market Access figures out how much to bribe and kickback ("rebates") payers for preference or avoiding PAs or steps, without overpaying, or, if in the medical benefit space, causing an ASP death spiral.

The problem is, most payers can't afford to disrupt existing cash flow to switch or sub, even for a quarter, and would still rather deny, delay, and defend.

Then that takes the conversation back to the original question. What does Market Access actually do?

 

[anonymous]

In general, Market Access figures out how much to bribe and kickback ("rebates") payers for preference or avoiding PAs or steps, without overpaying, or, if in the medical benefit space, causing an ASP death spiral.

The problem is, most payers can't afford to disrupt existing cash flow to switch or sub, even for a quarter, and would still rather deny, delay, and defend.

"deny, delay, and defend." Sounds like Paratek corporate leadership.

 

[anonymous]

If senior leadership dosent want to discount and the payers don’t want to cover it. Then why do we need a Market Access Team?

 

[anonymous]

If senior leadership dosent want to discount and the payers don’t want to cover it. Then why do we need a Market Access Team?

In order to drain the company resources and make it look like they are busy.