Can I ask you a question?
You have a medicine launching in 2028.You’ve already started planning for NICE approval. Box ticked. What comes next?
For many organisations, that is where the thinking stops.
NICE approval becomes the milestone everyone is working towards. Project plans are built around it, timelines count down to it and launch activities gather pace as the decision approaches. But NICE approval is only one milestone on the journey to patient access.
Over the past year, I’ve had two very different conversations with pharmaceutical companies. One was preparing for a launch in 2026. The other was planning launches in 2028 and 2029. If I asked you which organisation was further ahead, I suspect most people would choose the one launching first. You’d be wrong.
The first company approached us in late 2025. They were expecting NICE approval in the second quarter of 2026 and wanted to deploy our market access team at that point.
Based on our experience, I recommended they didn’t wait until NICE approval to begin their market access activities.
There was simply too much that needed to happen beforehand if they wanted to maximise adoption. Account mapping and prioritisation. Understanding local pathways. Identifying best practice sites. Preparing stakeholders. Laying the foundations that would help turn national approval into local implementation.
Planning for NICE approval without planning for market access is a little like building a beautiful theatre, creating an outstanding production and selling every ticket, but forgetting to build the roads that allow the audience to reach it.
The theatre exists.
The audience wants to come.
But they still can’t get there.
To their credit, they listened.
Rather than waiting until NICE approval, they brought us in immediately and started laying those foundations months earlier.
A few months later, I had a very different conversation. This company wasn’t launching in 2026. They were planning launches in 2028 and 2029. Their starting point wasn’t, “When should we start?” It was, “We need to get market access right.”
Traditionally, their organisation would have focused on securing NICE approval and then deploying a large sales force afterwards to drive uptake.
But they recognised that approach may have worked in the past, but not in the current environment.
Reaching and engaging the right stakeholders earlier in the pathway has become critical. And they knew they didn’t yet have that market access capability internally.
Rather than trying to build it from scratch over several years, they chose to partner with specialists who already had it.
They could accelerate their preparation, access proven expertise when they needed it and scale that support as their programme evolved.
It wasn’t simply a resourcing decision.
It was a strategic one.
Both conversations taught me the same lesson. One organisation realised they needed to start sooner. The other realised they didn’t need to build everything themselves. Both understood that market access doesn’t begin after NICE approval.
It begins long before it.
Perhaps the organisations that achieve the strongest launches don’t just start earlier.
Perhaps they ask better questions earlier.
Not simply: “When do we expect NICE approval?”
But: “What comes next?”
And: “Is market access a capability we need to build, or should we partner with specialists who already have that capability?”
I’d be interested to hear your perspective.
If you have a launch planned over the next few years, when does your market access planning begin? And how are you thinking about the capability you’ll need to deliver it?
Next month, we will explore why this question has become even more important. Recent changes across the NHS are reshaping market access, and understanding those changes is now essential if you want to turn NICE approval into timely patient access.
