Anticipating the top seven global market access trends for 2024: Cencora’s healthcare landscape outlook 

While groundbreaking legislative changes and increasing global pricing pressures may be the clear headliners, there are other changes — state-of-the-art technological and medical innovations, the growth of potentially curative therapies — swirling against a backdrop of uncertainty across different geographies. In the United States, the Inflation Reduction Act will not only accelerate pricing pressures on high-cost, highly utilized products, but it will also lead to downstream patient access impacts. Globally, payers continue to expect that manufacturers demonstrate the value of their products to the healthcare system and patients.  

In light of this ever-changing environment, Cencora’s market access team offers insights on the top trends that are changing the face of market access. In 2024, all stakeholders will need a clearer understanding of how these dynamic trends will affect patient access to innovative therapies across global markets.

1. Drug pricing pressures

While drug pricing pressures have been a reality for manufacturers for years in most global markets — specifically the European Union (EU) — these pressures are emerging as a new reality for industry within the United States.

Key focus areas for 2024:

• The Inflation Reduction Act (IRA) is ushering in a new era of government price scrutiny, negotiations, and pressures for manufacturers.
• Negotiations in Medicare are likely to have future impact on innovation throughout industry.
• Medicare Part D redesign will cap out-of-pocket costs for patients, but manufacturers and Part D plans must share in the cost burden.
• Higher financial liability for Part D plans is likely to lead to narrower formularies, greater utilization management, higher premiums, and less plan availability in 2025.

Similarly, in Europe, the European Commission published its proposal in April 2023 to reform the EU's pharmaceutical legislation.

• A key objective of this legislation is to reduce drug prices by enabling earlier market entries of biosimilar products and facilitating exchanges of best practices on pricing and reimbursement between member states.¹

2.  Complete EU market access footprint

Significant legislative changes in Europe loom on the horizon over the next few years. While the most prominent is the EU Health Technology Assessment Regulation (HTAR), the European Commission has proposed a pharmaceutical package revising general EU pharmaceutical legislation and making medications more accessible and affordable. Individual member states are also crafting other healthcare reforms.

Key focus areas for 2024:

• In Spain, a Royal Decree aims to revamp HTA regulation by introducing changes to governance bodies' structures and processes, in addition to implementing health economic assessments inspired by the UK's National Institute for Health and Care Excellence (NICE) approach.²
• In Italy, there have been significant reforms to the Italian Medicines Agency (AIFA), including merging the Technical and Scientific Committee (CTS) and the Pricing and Reimbursement Committee (CPR) into a single entity called the Scientific and Economic Commission for Medicines (CSE). This unified body will have the responsibility for conducting scientific assessments as well as making pricing and reimbursement decisions.³
• The objective for both is to ensure equal access to innovative medicines and new medical devices within individual countries and across the EU, specifically the following:
  • Reducing bureaucracy and redundancy across member states
  • Speeding up access to innovative medicines
  • Easing patient affordability challenges with greater price transparency, innovative payment schemes, population health models, and outcomes-based agreements.

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