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Are alternative access pathways the key to success for small pharma in European markets?

By AmerisourceBergen

Health Economics  Market Access Solutions

Authors: Katrin Falk, Karlien Van den Eynde, and Anna-Karin Bostrom

Health Economics  Market Access Solutions
Standard health technology assessment (HTA) processes for reimbursement of new drugs can be resource-intensive for small to mid-size pharmaceutical and biotechnology companies. These processes often require significant time and financial investments, which may outweigh the expected revenues, leading companies to forego launching their products in certain markets. Unfortunately, this deprives local patients of important therapeutic options. 

Recognizing this challenge, our team of Market Access and Healthcare Consulting experts embarked on a research project to identify alternative access routes that could provide viable options for small pharma companies. The results of our study, presented at the ISPOR Europe 2023 conference by Katrin Falk, Anna-Karin Bostrom and Karlien Van den Eynde, shed light on the availability and potential benefits of these alternative pathways.
Health Economics  Market Access Solutions

To address the resource-intensive nature of standard HTA processes for reimbursement, some countries have implemented alternative/abbreviated access pathways (AAPs). These AAPs aim to ensure local patient access to important therapeutic options while alleviating the burden on small pharma companies. 

Our team of experts initiated research to assess 13 European markets for existing AAPs, summarizing their differences and similarities. 

“Our motivation for undertaking this research stemmes from our ongoing work and advice provided to small pharma companies. We observed that navigating traditional access pathways often posed significant challenges for these companies due to the laborious nature and resource requirements involved. With this in mind, we advice small companies to explore alternative access routes that could offer a more streamlined approach while still reaching a substantial patient population within specific markets”
- Katrin Falk, Associate Director, Global Market Access Strategies


AAPs exist in most European markets, particularly benefiting small and mid-sized companies with flexible data requirements. However, it was observed that smaller markets tend to exhibit greater flexibility in implementing them compared to their larger counterparts. Unfortunately, the potential benefits offered by these alternative pathways are often overlooked or underestimated. 

Download the poster to learn more unlock opportunities for streamlined market entry strategies. 


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Moving forward, our Cencora experts will continue their research and policy observations, which will be essential to monitor developments regarding alternative access pathways across different European markets. Our unique expertise and extensive local teams allow us to provide tailored support for small pharma companies operating within various European markets. We at Cencora understand the nuances specific to each market and are equipped with experienced teams who maintain direct contact with relevant agencies throughout the various access process within a targeted market.

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Stay up-to-date with changes and advancements in this area, we can provide comprehensive guidance to pharmaceutical clients seeking optimal routes for their products' market entry strategies. Contact us to learn more. 


This article and the poster referenced herein is intended to communicate Cencora’s capabilities which are backed by the authors’ expertise. However, Cencora strongly encourages readers to review the references provided with this article and the poster and all available information related to the topics mentioned therein and to rely on their own experience and expertise in making decisions related thereto.



Katrin Falk
Associate Director, Global Market Access Strategies 
Manager Market Access BENELUX
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Anna-Karin Bostrom
Senior Manager Health Economics & Outcomes Research