Evidence-based value and access strategies

Case Study: Payer Strategies to Control Costs through Adoption of Access Management Tools

Return to Evolution of Payer Market

For a top pharma company, Compass provided an assessment of current and future access management strategies in a competitive therapeutic area

Client requested a characterization of payers’ pricing and access strategies through 2020 for current and pipeline products covered under the pharmacy and medical benefits in an effort to inform their business development assessments and strategies

Key Objective:
Identify strategies that payers may adopt in a competitive category as the market evolves and create a comprehensive landscape with an estimate of the likelihood of adoption of strategies by year

In-depth interviews with 9 US medical and pharmacy directors who are members of formulary committees and have responsibility for 60 million commercial lives


  • Identified current access management strategies in use by plans in the category
  • Identified specific management strategies that payers expect to adopt in the future in both the medical and pharmacy benefits and timeframe for adoption
  • Identified impact of scenarios such as price increases, entry of generics, and pipeline products on future management strategy
  • Identified expected prices for pipeline agents and evidence needed for premium pricing


Sample Deliverable
In the category assessed, increasing treatment options with few innovations will lead to decreased payer willingness-to-pay and more restrictions