Key Trends in Asia-Pacific

1. Who are Fishawack Health and how have they built out their APAC functional expertise in the value, evidence, and access (VEA) category?

Fishawack Health (FH) is a leading global commercialisation partner for the biopharmaceutical, medical technology, and wellness industries. FH was created to offer integrated services for pharmaceutical and biomedical development and commercialisation across four core disciplines—Consulting, Medical; Marketing; and Value, Evidence, and Access. Each of the disciplines are brought together under a client partnership model, which connects clients with the broader capabilities of the group.  

Under this model, we develop bespoke teams around each client’s challenge. These teams work independently but also collaborate across our four capabilities and 22 offices in North America, Europe, and Asia to give clients access to a seamless and agile strategy that meets their stakeholders’ needs. We have strong scientific skills with over 200 medical experts and writers, and over 150 PhDs on the team.  

FH’s commitment to growing capability in health economics and outcomes research (HEOR) and market access began with Skysis and PRMA Consulting joining the group in 2020 and 2021, respectively. With the addition of PAI, FH now has one of the largest and fastest-growing teams dedicated to VEA, all elements of which are critical to the commercial success of new products. We have broadened our specialism beyond market access.  

With the addition of these services and expertise, FH works end-to-end across the product lifecycle, ensuring the initial strategy is seamlessly executed across the product and portfolio lifecycle at every stage of the journey from early clinical to launch and beyond, driving better health outcomes for patients and greater business results for our clients in the biopharma, med-tech, and wellness space.  

2. What are the current trends and challenges in the APAC VEA landscape that FH is helping clients solve?

Governments are increasingly looking at and learning from each other, though this has different implications in the mature markets versus the emerging markets; these are discussed in this article: “A holistic approach to market access in emerging markets”.  

Our support for clients may also differ depending on the market archetype.  

In the mature markets, where the use of health technology assessment (HTA) is well established, we see several key trends for 2022 and beyond.  

First there is a streamlining of processes in these markets, especially for rare diseases and cell and gene therapies, covering both domestic processes and when compared with global standards.  
Secondly, we see HTA agencies increasing in importance in reimbursement decisions, moving from being technical advisors to becoming decision-makers themselves.  

Thirdly, the importance of locally generated pharmacoeconomic data, especially real-world data, is increasing. Many Asian regulators have long required local clinical data, and this is now expanding to payer requirements as well.  

Finally, we see increasing use of managed entry agreements and other risk-sharing agreements by payers to address their concerns about the higher cost of some of the highly innovative new therapies.  

In these mature markets, we help our clients develop strategies and navigate local requirements for achieving optimal access for their products in systems with well-defined structures and processes.  

3. And what are the trends and challenges in the emerging APAC markets?

In the emerging markets, as their healthcare systems and payer structures are evolving, the trends and challenges are both more basic and more complex than in the mature markets.  

First of all, governments in emerging markets are expanding their use of HTA with a focus on capacity building. Many countries have been influenced by NICE in the UK, both as a benchmark system but also as NICE has actively advised governments in the region. Increasingly, emerging markets have also been influenced by Thailand’s HITAP as a more relevant local example.  

Secondly, budget impact and pricing will remain the primary concern in emerging markets, with limited opportunities for advanced medicines, as HTA agencies in these markets are more focused on ensuring that essential drug lists are securely supplied with generics and biosimilars.  

Thirdly, as public coverage remains focused on basic care, private insurance continues to grow and is becoming a focus of innovation in expanding access to medicines.  

Finally, the impact of digital health on access, especially with the rise of telemedicine during the pandemic and the emergence of “super apps” as healthcare players, is still evolving in terms of closing the gaps in access to healthcare delivery and funding in emerging markets.  

In these emerging markets, we help our clients tailor strategies for evolving local requirements, explore innovative approaches to expand access, and build capabilities in their local and regional access teams.  

4. How does the PAI acquisition by FH deliver full-service capabilities to their clients in the APAC region?  

Both FH and PAI have operated in global markets for many years, and both understand the drug development and commercialisation needs of the regional and national markets.  

FH has brought together best-in-class global expertise with multidisciplinary skill sets and deep knowledge of both the HEOR and the payer landscapes in Europe, North America, and the Asia-Pacific region. With this global reach, we can build bespoke, best-in-class teams around the client’s challenge, bringing in expertise across the capability and the organisation.  

PAI’s team of more than 30 professionals is joining FH’s growing team of strategy consultants and technical experts. By welcoming them to the group, we are realising our vision of building a truly global integrated technology enabled consultancy, partnering with clients globally across market access, strategic pricing, health economics, and policy.  

With the addition of PAI, we have broadened our specialism beyond market access. PAI’s core capabilities include HEOR strategy development, evidence-generation planning, economic modeling, real-world evidence, and trial-based data analytics, evidence synthesis, and HTA.  

5. Gerry Oster, PhD, Managing Partner of PAI has played a very important role in the growth of HEOR over several decades. What will his role be in the new organisation?  

Gerry is one of the industry’s leading health economists and will become FH’s Global Head of Health Economics. He will also serve as an internal expert and external thought leader across FH’s various businesses, while also helping to shape the overall vision for VEA. In his 30+ years in HEOR, Gerry has authored more than 200 publications in top-tier journals and consulted on HEOR strategy and evidence generation for more than 100 biopharma companies; he will continue to leverage his expertise with clients and team members alike.  

6. How are digital applications helping to accelerate access in the APAC region?  

With APAC markets each having distinct characteristics and priorities, developing the right evidence generation strategy requires insight, agility, and collaboration. A good approach is for global or regional teams to identify the resonant issues across all markets, and then work closely with affiliates to filter out which of these make sense in the local context – it isn’t easy. To get there, companies need a consistent framework for assessing evidence risk across markets; informed, collaborative, and integrated decision-making; an integrated evidence generation plan; and enhanced prioritisation at the regional and/or market level.  

So how can you achieve it? Technology is a great enabler. We’ve supercharged our expert knowledge of the payer landscape with digital innovation that gives market access teams rapid access to insight that informs their evidence generation strategy. FH suite of digital applications includes the PRMA Healthcheck®, which provides a systematic and consistent approach to analysing the various factors that influence APAC pricing, reimbursement, and market access.  

In addition, PAI has developed hēRo3, a cloud-based economic modeling platform used for evidence reviews for new prescription drugs, medical tests, and other healthcare interventions. This platform significantly increases transparency, reduces errors, and speeds evaluations. Since its introduction, hēRo3 has been used by more than a dozen large biopharma companies, colleges, and universities around the world, as well as the largest drug-pricing watchdog in the US. We plan to roll out hēRo3 to our clients in APAC this year.  

7. What sets FH apart from other solution providers for life sciences commercialisation?  

With a new leadership team – including Chief Executive Officer, Jon Koch, and Chief People Officer, Liz Landon – FH has ushered in a new phase of growth and impact, focused on delivering an integrated and innovative end-to-end service offering. To support its accelerated global growth, FH has built a people-focused environment where employees are empowered to think differently, thrive, and produce award-winning work that meets the evolving needs of biopharmaceutical, medical technology, and wellness clients.  

The company re-imagined its vision and values, unifying its 1,300 global team members under a common aspiration: “We imagine a healthier world and create the connections to make it happen.” This new purposeful vision emphasizes a culture of diversity and collaboration, empowering teams to work cross-functionally to develop effective solutions to healthcare’s most complex challenges across the product, service, and portfolio lifecycle.  

FH has created a fresh way to develop, launch, and grow brands, offering a full suite of best-in-class services for development and commercialisation of pharmaceutical and biomedical therapies. We shape and affect connections between people and life-enhancing therapies, empowering people with the knowledge and the motivation needed to improve outcomes.  

In the two decades since our founding, we have built capabilities in medical and marketing consulting and, with the addition of PAI, we also have unsurpassed capabilities in the critical realm of VEA. By combining our skills in integrated teams, we are ready to deal with complexity and the ever-changing needs of commercialisation.