LEARNINGINACTION
By Gayle Shaw-Hones, Ph.D., Alex Moore and Christopher Pollack
Figure 1
Market access pull-through is facing renewed attention in the life sciences industry, with companies rethinking approaches to this strategic process to convert favorable payer coverage into actual product prescriptions and sales. To capitalize on payer wins and underperforming contracts, they are leaving event-driven pull-through behind for a more comprehensive approach that cultivates ongoing behavior change, broader access messaging and sustainable action across their field forces.
This change took center stage at TGaS’s 2025 Fall Summit event for heads of learning and development at life sciences organizations. Conversations with these experts painted a clear picture of what’s changing about market access pull-through.
Event-based approaches to driving market access pull-through are characterized by one-off formulary announcements, when a product gets approved by a payer. That’s certainly a win, but if a company doesn’t pair a market access strategy for sales and marketing, providers may still hesitate to prescribe due to perceived access or affordability issues, even when a product will help their patients.
And here’s an open secret: A lot of companies don’t have a strong access and affordability messaging beyond making formulary announcements. As shown in Figure 1, companies often struggle with shared issues around building effective pull-through strategies. Some top concerns include unclear company commitment and culture, lack of consistency and focus, a lack of sales force knowledge and acumen, missing or unreliable data and misaligned incentives.
However, a lack of ongoing messaging is a symptom, not a cause. They all point to the same thing: The need for more focus and process to address healthcare providers’ (HCP) cost and coverage concerns over time. When companies treat formulary win announcements as isolated events and not as part of a broader messaging strategy, they miss opportunities to build HCP confidence when prescribing.
A continuous approach to market access pull-through involves three major components: Your specific payer opportunity, your affordability programs and your access message (Figure 2). Each one is important for driving customer engagement and therapy selection.
First comes focusing on specific payer opportunities, such as 98% coverage, underperforming contracts and new government policies. In a continuous pull-through approach, companies build communication strategies around specific contract wins and other market triggers. This builds a “muscle memory” among field sales teams, who learn how to learn, so to speak, when it comes to building on existing core access messaging.
The next part of a continuous pull-through approach is reassuring providers of affordability programs and other patient support supplements. Companies should see a covered patient as only partway toward meeting their objective, which means every sales representative should have resources and messaging to not just show clinical efficacy and safety but also prove that a given treatment choice will be covered and affordable for their patients.
Then comes high-level access messaging. Access messaging in a continuous pull-through approach involves constantly reinforcing one clear message around your cost and coverage for patients. This message should be well-coordinated with field matrix teams, such as field sales, field reimbursement, regional payer teams, patient liaisons and field trainers. The more people rowing (or rather, communicating) in the same direction, the better. This helps HCPs provide good patient experiences, which leads to more starts and more persistent therapy.
Figure 2
For most companies, moving past event-based pull-through involves addressing strategic barriers:
Learning and skill development gaps
Cross-functional coordination and ownership
Provider engagement
Technology
Analytics and metrics
The first barrier, learning and skill development gaps, comes from a low-touch approach to educating sales representatives. Most market access and pull-through trainings are infrequent, packaged as self-directed online modules with minimal follow-up, regardless of therapy or account type. While this certainly gets a box checked, it doesn’t provide the hands-on skill building needed to keep representatives and account managers from feeling overwhelmed and underprepared. Instead, training should provide hands-on practice with handling objections around affordability and access, with strong accountability and feedback mechanisms.
The second barrier, cross-functional coordination and ownership, has the potential to waste resources and cause missed opportunities. After all, how can you implement a continuous messaging approach without building accountability mechanisms that encourage the commercial organization to embrace it? Companies must drive alignment on their messaging throughout the commercial organization, through tools such as scorecards or sales goals that incorporate access and wins at the beginning of the year (with forecasted share growth).
The third barrier, provider engagement, involves preparing field representatives to respond to HCP concerns in all kinds of situations. How are you preparing your sales force to sell through situations like medical exceptions before access is formalized? Are you coaching them on how HCP engagement goes deeper than just delivering branded messages, but also extends to affordability?
The fourth barrier is around technology. The truth is that pull-through efforts depend on access to accurate payer data, actionable insights and tools that empower both representatives and managers to prepare for local challenges and handle nuanced objectives. Your tech infrastructure should enable these capabilities, empowering your organization to get the right training and information to the right representatives at the right time to drive continuous messaging from your field force.
The final barrier to continuous pull-through deals with analytics and metrics. Your organization needs to be able to report on key performance indicators that show both activity and outcomes around ongoing messaging. Activity metrics can often be simple: Can you measure your field force’s use of market access and pull-through training? Are you following your process to connect specific payer wins to affordability programs, and then cohesive messaging?
While insights and analytics around outcomes can be a bit trickier, they can often build on activity metrics. Can you link sales representatives’ use of market access and pull-through training to increased patient starts? What about comparing the time it takes to complete your process for transforming payer wins into messaging campaigns against the growth rate of new starts?
Gayle Shaw-Hones is vice president of learning & development for TGaS Advisors, a division of Trinity Life Sciences. Email Gayle at gshawhones@trinitylifesciences.com or connect through www.linkedin.com/in/gayle-shaw-hones-phd-rn-8319941/.
Alex Moore, MS, is director of L&D data science for TGaS a division of Trinity. Email Alex at alex.moore@trinitylifesciences.com.
Chris Pollack is vice president of market access solutions for TGaS a division of Trinity. Email Chris at cpollack@trinitylifesciences.com.
