The Benefits of AI-Driven Payer Analytics Solutions for Managed Markets and Market Access

Payer analytics solutions are critical to managed market and market access performance. Patients and providers increasingly expect personalized engagements, which require teams to sift through massive volumes of data to determine what’s most relevant to customers. Additionally, market access teams face the challenge of analyzing terabytes of data to determine the best pricing and reimbursement strategies to lead to successful brand performance and make drugs and treatments available to patients who need them. However, traditional payer analytics solutions are slow, lack flexibility, and aren’t particularly user-friendly. 

Artificial intelligence (AI) helps managed market and market access teams overcome barriers to data-based insights. “Augmented” data analytics solutions provide zero-code environments and incorporate various forms of AI, such as large language models (LLMs), machine learning, and deep learning, to make data analytics insights accessible to business users. Instead of working with a data team to spend weeks building a BI dashboard for the insights they need, users simply ask a question. An AI-driven analytics solution pretrained with life sciences data will understand users and respond with relevant, contextual insights on demand. 

Managed Market and Market Access Use Cases

With easy access to data analytics insights, managed markets, and market access teams can enhance performance and optimize outcomes in a wide range of ways, including the following: 

Contract Management:

‍Life sciences companies can use AI-driven analytics solutions to optimize contract management. Domain-specific analytics can help teams review and approve contracts, quickly search for information, and create dynamic dashboards that help maximize revenues. 

HEOR Analysis:

‍Analyzing data, such as electronic health records, claims, and patient data, can increase the accuracy of Health Economics and Outcomes Research (HEOR) analysis. Augmented analytics platforms can decrease time to insights related to comparative effectiveness and cost analysis for new drug or medical device launches.

Brand Elevation:

‍Managed markets/market access teams can use an AI-driven payer analytics solution to identify current key opinion leaders (KOLs) in each therapeutic area based on their publications, event participation, and other factors. This analysis can be the first step in building relationships with these industry leaders and leveraging their expertise to promote their brands. 

Strategy Simulations:

‍AI-driven analytics solutions can help teams create sophisticated predictive models to test the impact of their decision-making. A data-based simulation reduces risks and helps ensure better outcomes. 

Marketing Mix Optimization:

‍Teams can also leverage data analytics to determine the best mix of marketing activities, spending, and ROI tailored to different products, territories, and customer personas. ‍

Market Segment Analysis:

‍Teams can tailor marketing to specific segments of their customer lists based on patient demographics, provider details, and payer preferences. Targeting marketing will ensure that relevant drugs, devices, or treatments are accessible to patients and providers. ‍

Market Sentiment Analysis:

‍Augmented analytics, machine learning, and natural language processing (NLP) capabilities allow managed market teams to understand the attitudes and perceptions of patients, providers, payers, and policymakers. These analyses can provide insights into patient sentiments toward treatment options, drug efficacy, and costs. Additionally, analyses can reveal payer attitudes toward cost-effectiveness and formulary listings. ‍

Performance Tracking:

‍Teams can analyze market access data from payers, pharmacies, and pharmacy benefit managers with real-time visibility and insights that help improve performance across these channels. They can conduct relative payer assessments, track and trace brand-level performance, and calculate brand-level market share assessment.‍

Formulary Analysis and Planning:

‍With easy access to data-based insights, market access teams can use AI-driven analytics to analyze current formulary data to quickly see which drugs are covered by healthcare coverages and create strategies to help more patients and providers have access to their products. They can also use insights from the platform to study market share and customer behavior, find the root cause of changes, and adapt. ‍

Reimbursement Analysis:

‍AI-driven analytics platforms that automatically update as new data becomes available allow teams to track reimbursement data in real-time, including payer coverage, reimbursement rates, total chargebacks, and pending rebates. These insights can help teams improve market access and optimize revenue. 

The Advantages of a Data Culture

With easy access to insights, AI-driven payer analytics solutions give market access and managed market teams a practical way to build data-driven decision-making into their daily workflows. It’s not necessary to wait for new dashboards and analyses; users work productively without putting critical decisions on hold until insights are available. 

Augmented analytics’ ease of use and the better outcomes users see when they factor in data-based insights lead to enthusiastic user adoption, better market access and managed markets performance, and, ultimately, business growth. 

Download the white paper from the Everest Group, “Transforming the Life Sciences Commercial Function with AI and Augmented Analytics,” to learn more about the advantages of AI-driven augmented analytics platforms.