I’ve spent 11 years sitting in the back of hotel ballrooms, listening to people talk about "patient-centricity" while ignoring the structural barriers that actually keep patients from getting medication. Most pharma professionals treat summits like AMCP or THMA executive roundtables as a chance to pass out business cards and hit the open bar. That’s a waste of the company’s budget.
If you aren't leaving a conference with a list of actionable insights that you can implement on Monday morning, you didn't attend a summit; you attended a vacation. After a decade in managed markets, I’ve started keeping a rigid spreadsheet. I don't care about the keynote speaker's vision; I care about the specific payer executive who just admitted their formulary committee is struggling with a specific HTA pressure. That is gold. Here is how to cut through the fluff and actually get answers on affordability.
The Payer Reality Check: Market Access vs. Prescriber Reach
Far too many folks confuse "educating the doctor" with "accessing the patient." You can have the most enthusiastic oncology specialist in the country, but if the ACCC-level community provider doesn't have a clear path to reimbursement, your drug isn't getting prescribed. Period.
When you ask about affordability, stop asking about "value propositions" in the abstract. Ask about the disconnect between your clinical data and the payer's bottom-line resistance. If a PBM is blocking access, your prescriber reach is irrelevant.
Three Questions to Challenge Payer Strategy:
- "What is the specific threshold where your committee stops looking at clinical efficacy and starts looking solely at net-price cost-offsets?" "When we see a shift in health system adoption, how much of that is driven by internal pharmacy profit margins versus actual patient out-of-pocket exposure?" "Which digital tools in evidence generation have you actually trusted to adjust your reimbursement criteria in the last 12 months?"
Health System Adoption and Formulary Execution
If you are at ACCC national oncology conference payer engagement events a meeting hosted by The Health Management Academy (THMA), you are in the room with the people who make or break your uptake. Do not waste their time asking if they "like" your drug. Ask about their friction points. You need to know exactly why their formulary committee isn't moving faster.
Health systems are under immense pressure to control spend. If your pricing structure is viewed as a liability to their operational stability, they will find a reason to deny access. Your role is to understand the administrative burden your drug creates. Is the prior authorization (PA) process too cumbersome? Does it require too many digital touchpoints that their staff doesn't have time to manage?
The Affordability/HTA Pressure Table
Here's what kills me: when you sit down with a lead negotiator, don't guess. Use the following framework to get them to reveal their hand regarding affordability pressures and access pathway barriers.
Topic The "Vague" Question (Avoid) The "High-Impact" Question (Ask) HTA Pressure How can we show better value? What clinical data set were you missing during your last quarterly formulary review? Affordability How do we improve access? What specific co-pay structure would shift your tiering decision for this patient population? Patient Assistance Is our PAP working? What are the top three reasons a patient is denied enrollment in our program at the site-of-care level?A Note on "Digital Convenience" (And That Annoying Cookie Law Plugin)
I spend a lot of time reviewing the websites for these summits. If I see one more site where I have to battle a Cookie Law Info plugin UI element just to find the attendee list or the agenda, I lose my mind. These digital barriers are a metaphor for the industry: we prioritize "compliance" (the cookie banner) over "utility" (actually finding the information).
When you are scouting digital tools for evidence generation or reimbursement, apply the same filter. If the tool is harder to navigate than the ACCC conference registration page, your field teams won't use it. If the tool doesn't provide real-time feedback on why a reimbursement was blocked, it’s not an access tool; it’s an administrative anchor.
What Would I Do Differently on Monday?
This is the question you must ask at the end of every session. If you can’t answer it, you weren't listening.
On Monday, I don't want to hear about "synergy" or "streamlining" processes. I want to know who you talked to, what their specific pain point was, and what data you are pulling to address that pain point before the next quarterly review. If you met a payer lead from a large IDN, you should be drafting an email to your internal managed markets lead regarding their specific concerns about your Patient Assistance Program (PAP) design.
The "Who You Actually Met" Spreadsheet
Stop relying on memory. Keep a sheet. Track these columns:
Final Thoughts: Stop the Fluff
The industry is moving toward higher evidence thresholds and more aggressive HTA-style reviews. You cannot fight this with "networking" and "brand building." You fight it with specific data, clear answers on affordability, and a design for your patient assistance programs that actually accounts for the financial reality of the health systems you are trying to reach.
Next time you are at AMCP or THMA, close your laptop, put the business cards away, and start taking notes on the problems, not the people. If you aren't helping the payer solve their cost-management problem, you are part of the access barrier.