Payer Marketing as a Growth Lever: How Top Brands are Investing

For most of the last decade, payer marketing was treated as a supporting function. The brand team owned the relationship with HCPs. The DTC team owned the patient. Market access existed somewhere downstream, expected to clear the path the brand had already chosen.

That model is breaking. Not gradually. Right now.

The numbers tell the story. Deloitte’s Rethinking Market Access report attributes 57% of drug launch failures in the US to limited market access, ahead of inadequate market understanding (47%) and poor product differentiation (41%). The average pharmaceutical asset now costs $2 billion to bring to market, and roughly a third of US launches between 2012 and 2021 missed their forecasts. That is not a marketing problem solved by louder HCP campaigns. It is an access problem that lives upstream of every dollar a brand spends.

Top brands have started to act on this. Payer marketing is no longer a defensive function called in after the price gets set. It is becoming an offensive growth lever, integrated into brand strategy from pre-launch onward. Here is what that shift looks like, and what it means for brand and market access teams making investment decisions over the next 18 months.

Market access is now a brand growth driver, not a downstream filter

The traditional model assumed brand value got built with HCPs and patients, and market access translated that value into formulary position. Two forces have collapsed that sequence.

First, the Inflation Reduction Act. With the first set of Medicare-negotiated prices taking effect in 2026 at an average 38% reduction from 2023 list prices, the economics of US pharma have moved. Net price assumptions that anchored brand forecasts five years ago no longer hold. Brands that cannot articulate payer value with the same rigor they articulate clinical value are going to lose ground they didn’t expect to be defending.

Second, payer expectations themselves have shifted. According to Deloitte, more than 80% of payers now consider real-world evidence essential to their decision-making. Efficacy data alone does not move a formulary decision the way it once did. Payers want to know what happens in actual clinical practice, in real populations, over real time horizons. That changes what brands have to invest in, and how early.

The brands gaining ground are the ones treating payer marketing as a parallel track to HCP and DTC, not a sequential one. The value story is being built across all three audiences at the same time, with the same level of investment and creative ambition.

What top brands are investing in

When we look across our portfolio of pharma and biotech clients, and what industry research is showing more broadly, the investment pattern is becoming clear. Five areas are seeing disproportionate growth in payer marketing budgets.

Formulary submission materials built for clarity, not just compliance. The AMCP-format dossier remains the cost of entry, but how that dossier is structured, written, and supported with visual evidence increasingly determines how quickly it gets reviewed and how favorably it lands. Top brands are investing in dossier work the way they used to invest in brand launch decks.

P&T committee presentations designed for the room. Pharmacy and therapeutics committees are not the same audience as HCPs, and the materials that work in the field do not work in the boardroom. Brands are investing in presentation assets, leave-behinds, and rebuttal documents built specifically for the dynamics of P&T review.

Payer-facing visual aids and sales tools that match the rigor of HCP materials. For too long, payer-facing communication has been the last priority in the asset hierarchy. That is reversing. Account directors and market access teams are getting tools designed with the same creative discipline as DTC and HCP work, because payer audiences have the same threshold for production quality and clarity.

HEOR communications that translate the math. Health economics and outcomes research has always been the substance behind payer conversations. The new investment is in how that substance gets communicated. Budget impact models, cost-effectiveness analyses, and value frameworks are being designed to be read, used, and remembered, not just submitted.

Real-world evidence storytelling. With 80% of payers now treating RWE as essential, brands need RWE programs that produce data and communication strategies that turn that data into a narrative payers can act on. The brands winning here are integrating RWE planning into commercial strategy years before launch, not commissioning post-launch studies as an afterthought.

Cross-functional integration is the multiplier

The single biggest shift we see in well-resourced brands is structural. The payer team, the brand team, and the medical team are no longer working from separate playbooks. The same insight, the same evidence, the same value framework gets translated for each audience with consistency.

That integration is where the growth lever actually lives. Brands that align their HCP message, their patient communication, and their payer value story around one through-line move faster, defend price better, and recover from access setbacks more efficiently. Brands that keep these functions siloed pay for the same evidence three times and tell three different stories with it.

The 18-month picture

The brands that will lead the next launch cycle are already investing in payer marketing as if it were a brand function, because that is what it has become. The teams making decisions now about where to put pre-launch dollars are looking at a different math than the teams that made those calls in 2020. Market access cannot be the last conversation. It has to be in the first one.

If your brand or market access team is rethinking what payer marketing should look like in the current environment, that is a conversation we would welcome.