What makes a good UK market access consultancy?

What is market access?

Market access is the work that helps a medicine, medical device or health technology move from clinical evidence to funded patient use. A company may prove that its product is safe and that it works, but it must also show that it is cost-effective, affordable, practical to adopt and worth prioritising within a pressured health system.

Why does market access matter in the UK?

A product must be clinically strong, economically credible and practically adoptable. Market access advisers help companies determine:

• what clinical and economic evidence will be required;
• how NICE or another assessment body may evaluate the product;
• what price and access conditions may be achievable;
• which payers, commissioners and clinicians will shape adoption; and
• what the health system must deliver for patients to benefit.

The best firms advise on the central market access trade-off: how quickly a product can reach patients, how broadly it can be reimbursed and at what price.

Why do investors care about market access consultancies?

The best market access firms sit close to some of the most valuable decisions made by pharmaceutical, biotech, medtech and health technology companies.

They may influence evidence generation, indication sequencing, pricing, payer negotiation, patient access, launch strategy and post-reimbursement uptake. Their work can affect both the commercial potential of a product and the time required for that potential to be realised.

This makes market access more strategic than generic professional services. It also makes the sector difficult to diligence.

Much of the value may not be visible in assets, technology or headcount. It may reside in:

• senior judgement;
• trusted client relationships;
• access to relevant experts and decision-makers;
• reputation within a specialist market;
• proprietary knowledge and accumulated experience;
• the ability to anticipate payer or health-system objections; and
• the confidence to tell clients something difficult before an HTA body, payer or health system tells them later.

A central diligence question is whether this value belongs to the firm or remains concentrated in a small number of individuals.

How Mansfield Advisors supports investors and market access firms

Mansfield Advisors helps investors assess market access consultancies and adjacent healthcare advisory businesses. We examine where the firm creates value, the quality and resilience of its client relationships, the transferability of senior expertise, the strength of recurring revenue and the potential for organic growth, acquisition and adjacent service expansion.

We also advise the owners and management teams of market access firms on how to maximise their potential: sharpening market positioning, identifying the most attractive client and service segments, strengthening commercial processes, developing scalable propositions and determining which adjacencies offer genuine strategic value.

Our work is designed to distinguish a compelling market access platform from a collection of projects, individual relationships or loosely connected capabilities.

What do life science investors need to know about market access consultancy?

Market access consultancies occupy a specialist and important part of the healthcare and life sciences industry. They help pharmaceutical, biotech, medtech and health technology companies move products from clinical promise to reimbursed adoption. Market access is healthcare access – the right medical intervention, reaching the right patient, at the right time.  It is also intellectually challenging, highly varied and effervescent with innovation and cutting-edge science, while possessing purpose in its pursuit of improving health outcomes for all.

Market access consultancies exist to help manufacturers clear multiple hurdles, whether preparing for health technology assessment (HTA), evidence generation strategy, payer negotiation or health system preparedness. It means landing the clinical value story – underpinned by evidence and backed by clinical and patient consensus – and navigating the multi-layered commissioning structures of the health system.

The best market access firms sit close to the decisions that matter most to a life sciences company, bringing expert insight to inform the perennial trilemma of speed, breadth and price.

For life sciences investors, the challenge is that this is a people-heavy, judgement-heavy sector, which makes it harder to value than most professional services businesses. But given that even the biggest pharma companies with extensive portfolios in the UK and European markets value highly the market access advice they receive, here are the questions we’d encourage any life sciences investor to ask.

What separates a competent adviser from a really valuable one?

A competent adviser can explain the HTA pathway, prepare payer materials, or support a submission — and can navigate the myriad obstacles inevitable along the way. Even well-resourced big pharma will often find these execution services useful.

A more valuable adviser goes further: they act as a critical friend, offering sharp strategic analysis and asking the questions a client might not otherwise hear.

Claudia Rubin explains further: “Having started in patient advocacy, I have spent the past 15 years or so working with most of the large originator companies, as well as with smaller US and European biopharma firms. What I’ve learned is that my value as a trusted senior counsel was never about being more expert than the client in their own product, therapy area or business, they know that better than I ever will.”

What really good consultants bring is a whole-system view drawn from coal-face experience: an interpretation of process and execution shaped not just by the rules of engagement, but by a nuanced sense of the art of the possible, and the confidence to challenge deeply held corporate assumptions  sometimes at a global level — while still pursuing the company’s highest ambitions.

Clients may arrive knowing exactly what “solution” they are bringing. Market access consultants help them define clearly the actual healthcare problem they’re solving — disease symptoms, yes, but also the wider patient, carer and health system burden of the condition. And it means being honest about the new problems that “solution” likely creates: the diagnostic capacity a new medicine demands, the more complex or reshaped patient pathway needed, the additional patients presenting to a system that were otherwise managing alone.

That’s judgement, not process. The real value a consultancy brings is the ability to see a client’s product not as the client sees it, but through the eyes of a regulator or health system — anticipating the questions, the trade-offs and the objections long before they’re raised.  For investors, that’s the marker worth looking for: a firm that thinks like a payer, while hailing from industry itself.

How early is the firm brought into the client’s value-critical decisions?

Market access advice can be valuable at almost any point in a product’s development lifecycle, but the earlier it starts, the more it shapes outcomes; considered decision-making through clear strategic thinking often saves time and money. It can also give country affiliate teams and their regional head offices the space to come to difficult decisions together. Indeed, the greatest return is often felt through longstanding partnerships. Knowing early where the obstacles will likely lie — and the steps to take to mitigate them — should make the hugely resource-intensive process somewhat more efficient.

It is never too early to start considering launch strategy through the market access triangle: speed, breadth, price. While manufacturers would prefer not to compromise on any of these, pursuing the highest in one is likely to put downward pressure on at least one other, and so this becomes a key early strategic decision that may shift over time.

Evidence generation planning should ideally begin around Phase I and evolve as both internal data and the external market shift. A good adviser brought in early can influence trial design, launch sequencing, payer and patient engagement, and pricing corridors, forging the best path on to the HTA submission.

In diligence, investors might test when a firm is typically engaged: pre-Phase III, pre-submission, launch preparation, or after a rejection or funding decision goes wrong. Early engagement is usually a strong signal of genuine strategic relevance, as is those brought in to resolve complex affordability questions or managed access arrangements.

How deep are the client relationships?

In a heavily regulated, reputation-sensitive sector, a logo on a website tells an investor very little. What matters is whether clients come back — across assets, indications, geographies and budget cycles. A firm with a handful of deep, recurring relationships across the top of pharma is usually worth more than one with a long list of one-off engagements.

The strongest signal is expansion: a project that starts with a single product team and grows into other indications, therapeutic areas, regional markets, and eventually above-country teams. That pattern of a client’s trust widening over time is a much better indicator of durability than headcount, profile, or a project’s initial size. A retained client advisory model may be a sign of a fruitful and trusting partnership.

There’s a clear personal dimension too: you’ll often find advisory firms following key clients as they move to new roles in the industry. The intense working relationship, forged over the long months of a high-pressure launch process, can lead to a close, trusting bond between a client and their dependable senior counsel.

For diligence, the investor question is whether those relationships can survive growth. A founder-led or partner-led firm can be highly valuable, but valuation depends on whether the trust can be translated into a broader operating model: repeat methods, trained managers, quality control, and enough senior coverage that the firm is not entirely dependent on one or two individuals.

What does high-quality recurring revenue look like?

Recurring revenue in market access should not be judged solely by the presence of a retainer.

A monthly report or advisory call may provide revenue visibility, but it does not necessarily demonstrate strategic dependence. The better question is whether the consultancy has become part of the client’s decision-making rhythm.

High-quality recurring revenue usually has three characteristics.

First, it is connected to live and important decisions: evidence planning, pricing, payer engagement, policy change, launch sequencing or emerging access risk.

Second, it generates pull-through work. A retained relationship may lead to payer research, advisory boards, evidence strategy, launch planning, value communication or managed-access support.

Third, the relationship is institutional rather than purely personal. If all trust rests with one senior adviser, the revenue may be repeatable but not fully transferable or scalable.

Is the firm differentiated, or simply experienced?

Experience with HTA, the health system or with payer research is now the baseline expectation — most credible advisers in this space can claim it. Differentiation comes from something sharper: deep expertise in a specific area such as oncology, rare disease, cell and gene therapy or innovative access schemes; proprietary tools or data assets; or genuinely strong industry insight, built over years rather than one engagement.

It also comes from clinical credibility. Healthcare systems are, and must remain, clinically led and patient centred. A firm with embedded clinical advisory expertise, informing strategy from the outset and throughout, brings a different quality of insight than one relying on market access theory alone.

The test for an investor is straightforward: why would a sophisticated life sciences client choose this firm over its named competitors, or over building the capability in-house? “We know the process” is not an answer. The firms that answer convincingly tend to share the same markers — origination that runs deeper than one or two individuals, strong repeat revenue, and a delivery model with room to grow.

Why does a licensed medicine still need help reaching patients?

Around 40 to 50 completely new medicines are licensed in Europe and the UK each year, alongside thousands of new medical device registrations.  Some will reach patients relatively straightforwardly, and manufacturers may be well set up to achieve this.

These processes vary significantly by jurisdiction and are typically complex, though many countries offer facilitated pathways that support early engagement with regulatory and HTA bodies.  ILAP in the UK is a fast-track pathway that helps promising innovative medicines and health technologies reach NHS patients sooner, through coordinated regulatory and health technology assessment support. The system is generally set up for good bilateral dialogue between parties, aiming to get the right cost-effective health interventions to patients, quickly.

It is not a zero-sum game, however. The true test is not whether your product will or won’t be reimbursed — indeed the vast majority (85%) of NICE HTAs for medicines are approved in one way or another. The key question is what negotiations have taken place to get to this decision — what has been compromised in terms of speed, breadth of access or price?

A small number of highly specialist firms are called in only after a rejection or funding decision has gone wrong. Here, clinical judgement matters most of all: where an intervention has real clinical value, there is usually a shared determination to reach agreement — and the right advisers can broker a way through.

And that’s just the HTA decision. Unfortunately, it is not unusual for HTA-approved medicines to struggle to see the kind of uptake their clinical profile might have promised, and which the company might have been expecting.

A shiny new plane analogy is helpful here; it may not matter how fabulous the product is, if there isn’t the infrastructure around it to help get it airborne — a suitable runway, terminal, baggage handlers, ground crew and air traffic control — then that plane is likely staying in the hangar. Likewise with innovative, increasingly personalised medicines: early thinking about additive costs for, or changes needed to, the health system will be asked not only in the HTA process, but will be necessary for delivering wide, rapid and equal patient access. While many jurisdictions have moved away from using complicated managed access schemes, there is still a clear role for industry-supported uptake programmes, particularly with big population-level interventions like the SGLT2 inhibitors or GLP-1s.

Market access consulting is about building the runway as well as selling the aircraft — thinking, from the earliest possible moment, about how an asset will be perceived through payers’ eyes and patients’ lives. Get that right, and a product doesn’t just receive a licence. It reaches the people it was built for.

What ultimately drives valuation?

A premium valuation is most likely where a market access consultancy combines strategic influence, repeat client demand, differentiated expertise and a delivery model that can scale without losing judgement.

The strongest businesses are not just collections of senior experts. They have client relationships that deepen over time, methods that can be taught, managers who can deliver much of the work, and senior advisers who are brought in early enough to influence the decisions that matter. They are close to the commercial questions that determine whether healthcare innovation is funded, adopted and used.

How can Mansfield Advisors help?

We advise businesses and investors across Europe on healthcare strategy and M&A. That includes assessing market access in commercial due diligence, shaping market entry and expansion strategy, and supporting buy-side and sell-side processes.

Market access is one part of how we support pharmaceutical companies. Explore our pharma consulting work.