Access, reimbursement and pricing - a critical mindset to succeed. StoH# 17


Hello !

I like to do puzzles with my little one. This made me realize that my expertise today is like multiple pieces of a puzzle that perfectly match my clients' needs: access and pricing strategy + innovation management + AI and other digital health solutions design.

So here I will explain why access and pricing is a critical mindset and a skill to design successful digital health solutions and innovate in healthcare.

I also share 3 actionable checklists for you to apply and learn from my 20 years of experience in this field.

"Price is what you pay, value is what you get"
Warren Buffet

Get comfortable for your 5 minutes of sparks to hack.

✨ Spark

Market access, reimbursement, and pricing strategies ensure that your new solutions (whether a digital health algorithm, a medical service or a drug) will be available to your end users (such as patients, physicians, IT head) by ensuring a viable business model: 1/ you capture the right financial value, and 2/ budget holders (insurance companies, government bodies, or patients..) will pay for it.

✏ Why this matters

Market access, reimbursement, and pricing, aka "Access" are critical skills (and not only because I have worked in this field for so long 😉). Indeed, we face:

  • An increase in our elderly populations and chronic diseases like diabetes and cardiometabolic disorders.
  • More costly and complex treatments (like gene therapy).
  • Budget constraints from national social security and government.
  • A rise in insurance premiums (here in Switzerland, we again had an increase in the compulsory healthcare monthly premium of 8.7% compared to 2023 😱).
  • Increased complexity with multiple potential budget holders (patients, insurance government, employers, clinics...).

To ensure a successful launch of your new solutions, you need to have a solid strategy and understanding of Access.

✏ Not only a financial view of the system

While we define pricing strategy, the entire work of Access is around value, not price.

✏ Access fosters an ecosystem mindset

Access means addressing the needs of multiple stakeholders, who often have opposite wishes and expectations. This is true in the first country of launch but also in any other market you enter when you scale (I used to support countries from Latin America, like Brazil, to Canada, up to China or India).

This is why an ecosystem mindset developed in access will help you succeed in digital health and health innovation management. If you want to build an ecosystem mindset, ​here​ is a newsletter dedicated to this topic.

If you want to build an ecosystem mindset here is a newsletter dedicated to this topic.

✏ Data, data, data

Access means defining the data needed to support all your value claims. I used to design data generation plans for solutions 5 years before their launch. So, start with the end in mind and collect data, not only to convince your users and regulatory bodies like the FDA or EMA but also budget holders. Today, digital health and all monitoring devices help us to improve our data collection.

✏ Hire or develop an access generalist mindset

There is a difference between an access generalist and an expert. That's what I call 'breadth' vs. 'depth'.

Here, we look for breadth. Access, in terms of an ecosystem from multiple players and multiple markets, is where we embrace empathy and focus on value.

Hack

Now, I'm done promoting my Access colleagues (😉). Here are four actionable checklists for you to apply, even if you do not yet have expertise in this field

✏ 7 questions for more brilliant pricing strategies :

Often, I see teams defining their pricing strategy without data (this makes me 😡). By 'pricing strategy,' I mean determining the price of your solution (e.g., a medical device) and selecting the revenue stream (e.g., subscription fees for an algorithm). We have a section on pricing strategy with Canvas and checklists in the academy. Here is how we always begin to ensure the teams collect the appropriate data to help them define the right strategy.

  • What are your use case and your target market?
  • What is the payment system: mechanism of funding, reimbursement, budget holder & decision maker (who pays the bill)?
  • What are the needs and goals of the budget holder?
  • What is the cost of the problem you're solving?
  • What is the value of your solution vs. the main alternatives
  • What is the cost of alternative solutions & standard of care?
  • What will be the cost to produce and deliver your solution?

Once you have your pricing strategy and product's initial launch, maybe this next question arises 👇.

✏ Increase monetization of your solutions

“How can I better monetize my solution (a digital health application, a new delivery offering, or a diagnostic device) ?”.

If you ask yourself these questions, here are the 5 secret trigger questions I used in my coaching.

  • The data we collect - who would be interested in it?
  • The community we built - who would benefit from having access to it?
  • The resources or activities we have - what could be of value to entities other than our current customers or partners For example, an algorithm, your platform, or specific skills like logistics.
  • Which new budget holders/payers might be interested? (For example, transitioning from B2C to B2B)
  • The domino effect (my preferred one 😉): who will benefit from us being successful further down the path (e.g., in the customer journey after using our product, or in our ecosystem, someone more remote from our user)? Who can capture value from a business opportunity we created by being used?

✏ Deep understanding of the buying process

If you are in a Business to Business (B2B) setup, you must understand the buying process of the targeted organizations. Here are three steps to do so:

  1. Frame the Problem: Enterprise buyers seek solutions to specific problems rather than purchasing novelty.
  2. Identify the Champion: Identify the individual facing the problem rather than those merely enthusiastic about the technology. This 'champion' understands the challenge and has the budget to address it.
  3. Understand the Buyer’s Roadmap: Know the buyer's challenges and their internal processes, such as when they prefer to build tech internally versus buying externally."

Remember even in the organization, people make purchasing decisions 😉.

✏ Focus on value, not price

And finally, if you're challenged or questioned about your prices, no worries (this also happens to me 😅). Return to the value discussion and help customers visualize the benefits. Make it more tangible.

  • Show the way: guide them through the process.
  • Clarify the steps: break it down.
  • Illustrate who else will benefit from your offer beyond this customer.

I hope you will find this checklist helpful. Enjoy becoming an access generalist 😍!

And if you want to accelerate these results, "The Bambooster Academy" will help you.

It’s an online training and coaching session with me for early-stage teams in healthcare based on the insights of more than 500 healthcare teams coached like Roche, MSD or Pfizer.

It enables teams to reduce the time between technology or ideas discovery and significant investments or first paying customers.

​Feel free to check it below:


Bambooster Academy for healthcare teams here

Hit reply to let me know if you liked this edition or if you tried these tips. I respond to every person who writes to me!

See you in two weeks. Keep the spark alive, and be intentional :)

Spark to Hack ✧

Hi, I'm Aurélie, a professional coach and facilitator, specialized in innovation in healthcare and sustainability. I enable team and organization leaders in healthcare to increase the speed between an ideas discovery and significant investments. I bring creativity and disciplined methods with contagious energy and a smile as well as a team and system coaching approach. I have a No BlaBla, No Bulshit, and no Blingbling values. I am a entrepreneur / working Mum aware that I only have one life, so I want to make the most of it!

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