Jen examines why fragmented ownership across development, regulatory, pricing, distribution, and field functions undermines access at launch. She argues that naming a single accountable owner for the access outcome can close "access debt" earlier, reduce pre-launch friction, and turn coverage into real patient access.
Learn more about EVERSANA's approach to access.
Read on for Jen's insights.
The Industry Doesn't Have an Access Collaboration Problem. It Has an Accountability Problem.
By Jen Norton, President, Market Access & Value, EVERSANA
That model of singular, binary events no longer fits the reality of launch.
Today, access is shaped by decisions made across clinical development, regulatory strategy, pricing, distribution, affordability programs, and field execution. Yet many organizations still operate as though access can be owned by a single function.
The industry doesn't have an access collaboration problem. It has an access accountability problem.
The risk isn't that the right functions are missing from the conversation. It's that no one is clearly accountable for connecting the decisions that determine whether coverage ultimately becomes real access.
For launch teams, the question is no longer, "Did we secure coverage?" It's, "Can we consistently convert coverage into access, utilization, and demand?"
Where Access Debt Begins
Access challenges rarely appear for the first time at launch. They usually begin years earlier, when development decisions are made without enough thought to how payers, providers, and patients will experience the product down the line.
Call it "access debt": early decisions made in development that create reimbursement, affordability, or distribution barriers that don't emerge until launch. Clinical trial design, evidence generation, indication sequencing, pricing assumptions, and regulatory pathways all influence future payer behavior. When access implications are not considered early, launch teams inherit barriers they cannot easily fix later. A pricing strategy built without pull-through implications in mind, or a regulatory pathway chosen without an eye on downstream reimbursement, can become an access barrier years after the decision was made (and largely forgotten). The earlier these questions get asked, the less debt accumulates.
Where Access Breaks Pre-Launch
The final 12 to 18 months before approval are where access strategy is most vulnerable to siloed decision-making and handoff failure. Distribution, contracting, affordability, patient support, provider education, field reimbursement, sales, and marketing may each arrive at launch with a well-built plan; but if those plans are built in parallel instead of in unison, they create friction at the exact moment launch teams need speed and alignment most.
Distribution strategy may be optimized in isolation. Affordability programs may be developed without considering payer implications. Commercial teams may be trained on access assumptions that never materialize. Individually, each decision makes sense; collectively, they can create access friction.
A favorable formulary position does not guarantee access if providers struggle with benefit verification, specialty pharmacies create delays, affordability support is poorly timed, or field teams lack visibility into local coverage realities.
Where Coverage Still Has to Become Access
Launch is where many organizations confuse coverage with access. Coverage still must translate into provider confidence, patient starts, refill continuity, and sustainable gross-to-net performance.
A product can secure favorable coverage and still miss its demand goals — if providers perceive access as difficult, if patients hit affordability barriers, if field teams lack local coverage intelligence, or if revenue management doesn't have a clear view of contract performance.
From Access Activity to Access Accountability
The strongest launches make access look easy because the underlying operating model is aligned. Bridge programs, non-dispensing pharmacies working behind the scenes to navigate benefits, field teams with real access acumen, tight coordination between market access and patient services — each is one piece of a larger, carefully connected system.
The manufacturers who outperform in the next era of commercialization will not be the ones with the most access activity; they will be the ones with the clearest access accountability. That means naming a single owner for the access outcome, building formal access review gates into development and launch planning, and measuring success beyond formulary position alone. Coverage matters — but coverage is not the finish line.
Market access can no longer own access by itself. Nearly every corporate function has a role to play — from R&D to regulatory to trade and channel to field reimbursement. But someone still must be accountable for making the whole system work, holding a wide range of specialized contributors to one shared plan.
Patients are counting on us to get this right.
Explore EVERSANA's connected approach to access.
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