Pharma and medical device companies have limited budgets to spend on consulting services. The smartest companies ensure their investments answer a key strategic need and directly support launch success. Unfortunately, that is not always the case. Too often, manufacturers pay for research that sounds useful but does not deliver meaningful results.
When a manufacturer is preparing for a launch, leadership usually has two overarching payer questions in mind:
- How can we get covered with the fewest restrictions?
- How can we speed up the process to ensure the product is covered by insurance?
(I will write a separate piece diving deeper into these questions, but it is important to note that payers do not instantly cover new products. Most have a “new-to-market block” or default to prior authorization for 3–12 months while they finalize a coverage policy.)
These questions matter because the first few months of a launch often determine long-term success. Even a short delay in coverage can cause providers to view the drug as restrictive and avoid prescribing it. Once physicians decide a product is too much hassle, it can be very difficult to change their perception in the future. Providers already dislike the paperwork burden of prior authorizations, so if a drug feels like extra work, adoption suffers.
The Myth of “Speeding Up” Payer Coverage
Many manufacturers pay for strategy research on how to accelerate policy creation. The problem is that payers simply do not speed up the process. Manufacturers often believe they are unique, that their drug solves an unmet need, or that payers will make an exception. In reality, even if a product is a breakthrough, payers tend to view it as a financial risk, and they assume the price will be high and want time to put restrictions in place.
Policies are reviewed at set intervals by P&T committees. That is when coverage decisions are made, and no amount of research will change the calendar. If you want to spend six figures on consultants to confirm that, people will gladly take your money. In my experience, those resources are better spent on strategies that actually improve access.
The only time I have seen a company successfully accelerate coverage was in the case of a very expensive product with no competitors, where the manufacturer was willing to make major rebate concessions upfront before launch. This is the exception, not the rule.
Messaging Research That Rarely Pays Off
Another type of research that often disappoints is payer messaging work when the only advantage is convenience, better patient-reported outcomes, a unique delivery system, or a theoretical benefit. Those attributes rarely move payers.
In these cases, marketing dollars are almost always better spent on educating providers or patients, rather than trying to convince payers of a story they are unlikely to value. (As I wrote in Pharmaforum, payers want concrete clinical or financial benefits, not messaging built on softer attributes.)
Conclusion
Not all research is created equal. Some studies drive revenue and adoption, while others drain budgets with little return. Manufacturers should prioritize payer insights that influence real-world decisions: cost offsets, contracting strategies, clinical differentiation, and competitive positioning.
Convenience, delivery systems, or theoretical benefits rarely unlock coverage. And research aimed at speeding up payer timelines is almost always wasted spend.
The bottom line: focus your budget on strategies that change behavior and shape access. Everything else is noise.