Redefining Market Access: Turning Operational Barriers into Strategic Advantages

Specialty therapy access remains a major challenge. According to our 2026 State of Patient-Centricity report:

• For every ten patients prescribed, only six gain access and just three remain on therapy at twelve months
• 25% of biopharma companies list “Provider management” as their top priority, as HCPs and office staff remained overburdened with administrative hurdles and paperwork
• Increasing payer and regulatory complexity has led 20% of large pharma companies to list “managing Payer dynamics” as their top investment area

Combined with the growing increase in specialty medicines, these trends highlight the growing complexities and challenges facing Market Access teams - a function that is only becoming more strategically important.

In a recent webinar, our Market Strategy Lead, Rose Kozar, and Market Access expert from SageTree Collective, Katherine Chan, dive into why, and how, market access teams can engage more strategically and take greater ownership of the patient journey to drive better outcomes.

The reality is that the real barrier isn't intent, it's the operational infrastructure and conditions underneath it all. Getting the fundamentals right is the first step.

Building a Culture of Trust

Unclear roles and handoffs leave market access as the default glue holding everything together: FRMs double-check work that’s already been done, case managers solve problems that aren’t theirs to catch, and sales and access teams often work in parallel, sometimes even in silos.

Trust at the operational level comes down to three things:

• Role clarity across the ecosystem: Not just knowing your own job, but also understanding everyone else’s role and how it supports the team’s objective and program outcomes. Seeing the full system helps people stop trying to manage it all themselves.
• A culture of learning, not just reacting: Teams that feel safe raising issues and asking for help spot patterns sooner and ultimately resolve patient and provider-related problems faster. Structured, cross-functional coordination builds this culture over time.
• Operating models over manual coordination: When teams aren’t sure how or when information will be shared, work becomes reactive. Building trust and clear processes ensures information flows consistently and proactively, freeing teams from internal concerns, "swirl," and backdoor communications. This lets them focus more on what matters: creative problem-solving and driving higher-quality interactions to help patients start and stay on therapy.

Creating Holistic Patient Journey Visibility

Without visibility across the end-to-end patient journey, teams remain in the weeds, focusing only on the tough cases and issues that surface each day. Complex prior authorizations and frustrated or non-responsive offices stand out, while patients who move towards the next milestone smoothly can go unnoticed. As a result, teams - and strategy - tend to remain focused on outliers, instead of the real trends and patterns.

• Identify patterns, not just problems: Holistic patient journey visibility makes macro trends or consistent barriers (such as a consistently high PA denial rate, highlighting a key account that may need PA process re-education) clearer to identify. This helps leaders and teams separate isolated incidents from systemic issues that are impeding patient access.
• Move from reactive to proactive: With these insights, leaders can optimize their workflows and program SOPs to remove barriers and prevent issues before they arise.

"The best FRMs shift from 'I'm great at solving problems' to 'How do we get ahead of problems that we know are happening?' That can only happen with clear visibility across the program."
-Katherine Chan, Co-founder and Partner, SageTree Collective

How better visibility changes outcomes:

• One biopharma team moved from reacting to individual patient case alerts to a single system, giving FRMs and Sales compliant visibility into account partners that helped enable more efficient, strategic engagement. This helped them move from firefighting one by one to better educating providers upfront, resulting in a 14% lift in six-month persistency rates.
• A rare pediatric brand gave access managers visibility into dosing schedules, enabling more informed prior authorization conversations that drove 9% higher approval rates and a 10% drop in discontinuation rates.

Measuring What Actually Matters

When measurement is unclear, teams tend to default to what's easy to count: face-to-face visits, enrollment forms submitted, and cases logged. Activity metrics feel safe because they're familiar, measurable, and compliant. But they can drive the wrong behavior.

• Activity metrics drive activity: Focus on activity-based metrics can result in  "quantity over quality" and misaligned incentives. Activity metrics can actively penalize people for circumstances outside their control. For example, an FRM in a territory with more limited payer coverage may underperform compared to someone in a stronger market, not because they are less effective, but because the metric does not reflect their environment. This creates unfair comparisons, erodes trust, and skews how teams prioritize their efforts. Activity metrics aren’t going away but are now paired with outcome metrics to measure real impact.

• Outcome metrics orient around shared results: Shifting to outcomes focuses teams on what matters for patients. Here are key metrics we're seeing measuring real impacts:
  • Patient Start rates: This is increasingly used as a KPI, with strong leadership alignment ensuring teams stay within non-promotional guardrails across Sales, Patient Services, and Market Access.
  • Time-to-start: A straightforward number with a direct line to patient experience.
  • Access rate and PAP-to-covered transitions: Early in a launch, getting patients on therapy through any pathway (PAP, bridge, commercial) is the priority. As the program matures, the question evolves: are patients who no longer need financial assistance being moved to covered treatment?
• Measurement should evolve over time: What you track at launch won’t always work later, so metrics should evolve as data improves and programs scale.

"If it’s difficult to move away from rewarding activity volume, measure it alongside an outcome-based metric and see whether that engagement truly drives program success"
- Rose Kozar, Market Strategy Lead, Courier Health

Set the Stage for Market Access Success

Trust, visibility, and strategic measurement are the foundation for building strategic advantage in market access. When these are in place, teams solve problems faster, coordinate without bottlenecks, and clearly show the impact of their work.

Watch the on-demand webinar to discover how these concepts work in the real world.