Next-Gen Market Access Pull-Through: Eliminating Access Delays Through Intelligent Field, Hub, and Digital Coordination

Industries Profiled:
Health Care; Pharmaceutical; Diagnostic; Medical Device; Biotech; Manufacturing; Consumer Products; Biopharmaceutical; Clinical Research; Laboratories; Chemical


Companies Profiled:
Abbott; AbbVie; Alcon; AstraZeneca; Bayer; Boehringer Ingelheim; Caldera Medical; Daiichi Sankyo; Galderma; GlaxoSmithKline; Jazz Pharmaceuticals; Johnson & Johnson; Merck; Novartis; Novo Nordisk; PerkinElmer; Pfizer; Priovant Therapeutics; Sanofi; Smith & Nephew; Solvay; Takeda; Taro; Upsher‑Smith; Wyeth Nutrition

Study Snapshot

Best Practices, LLC engaged 33 pull-through and commercial leaders from 26 biopharmaceutical and medical device companies. Deep-dive interviews with selected participants complemented the survey findings, offering richer insight into how teams structure processes, leverage digital tools, integrate with specialty pharmacies, and operationalize payer strategy at the field level.

Key topics covered in this report include:

• Pull-Through Operating Models and Cross-Functional Coordination
• Payer Policy Navigation and Office Ecosystem Engagement
• Digital, Omnichannel, and AI-Enabled Pull-Through Capabilities
• Field Process Fluency and Reimbursement Expertise
• Specialty Pharmacy and HUB Integration Models
• Pull-Through Tools, Templates, and Metrics
• Area Manager and Field Specialist Best Practices

• Tools and Templates: More than half the participating companies use tools and templates to simplify or accelerate pull-through. The most-used tools/templates are for account prioritization (72%), physician education programs (66%) and account segmentation (63%). Tools or templates most often judged “highly effective” for pull-through support are account access training, account prioritization and physician education programs. More than 90% of respondents find some tools to be at least “moderately effective.”

• KOL Management: Speaker programs are the highest-rated KOL interaction tactic, with 35%
  of respondents finding them to have a high impact on pull-through effectiveness and 83% finding them to have at least moderate impact.

• FTEs: Ninety-three percent of respondents have employees with pull-through responsibilities in their Sales organizations, and two-thirds have them in Marketing. Other FTEs are primarily found in Contracting and Medical groups.

• Executive brief: Strategic imperatives for next-gen market access pull-through
• One-page executive summary framing the need for coordinated, modernized pull-through execution
• Participating benchmark organizations
• Therapeutic areas represented by the benchmark class
• Definitions used in the benchmark study
• Key findings about program types, education topics, and education channels that contribute to pull-through effectiveness
• Key findings about pull-through targets, tools, and tactics
• Key findings on KOL management, pull-through resources, and success measurement
• Key findings around top challenges

• Pull-through definition framework outlining its role in converting access wins into real-world utilization
• Exhibit summarizing the major access barriers
• Pull-through ecosystem map showing the interdependencies across medical, commercial, payer, distribution, and patient-support functions
• The six-pillar pull-through framework
• Pillar-by-pillar owner, purpose, core focus, and outcome map illustrating execution responsibilities across functions
• Pull-through role and objectives of Medical Affairs and Market Access & Pricing functions
• Pull-through role and objectives of Commercial / Sales (Field Execution) and Patient Services / HUB / Support Programs
• Pull-through role and objectives of Operations, Trade & Distribution and Analytics, Insights & Enablement
• Pull-through cycle as highlighted by a high-performing area manager
• Understanding and managing pull-through as an integrated system

• Prevalence of pull-through program types across benchmark participants
• Impact ratings illustrating which program types have the strongest influence on pull-through results
• Customer-group targeting overview
• Tools and templates used to support pull-through activities
• Effectiveness ratings for tools/templates showing which are viewed as high-impact in enabling consistent execution
• Leadership-role distribution exhibit showing which groups lead key pull-through activities
• District Manager vs. Account Manager role comparison illustrating how responsibilities differ in planning, message customization, barrier removal, coaching, and coordination
• Executive narrative around instilling a pull-through mindset across the entire sales cycle
• Tools and platforms used by benchmark organizations to support pull-through activities
• Checklist of highly effective pull-through tactics along with key elements

• Top healthcare-provider education topics most effective in driving pull-through
• Top patient education topics with highest perceived pull-through impact

• Impact of listed KOL interaction tactics on overall pull-through effectiveness
• Executive narrative and exhibit around targeting prescribers to maximize pull-through success
• Ideal scheduling frequency based on prescriber pattern
• Executive narrative and exhibit around useful factors for assessing primary targets

• Departmental locations of pull-through FTEs across sales, marketing, medical, contracting, and adjacent teams
• Metrics commonly used to measure pull-through success
• Exhibit showcasing messaging, collateral, and communication tactics to improve pull-through effectiveness
• Executive interview around formal practices for sharing best practices and solutions to improve pull-through
• Benchmark practices around setting goals, measuring, and analyzing pull-through initiatives to ensure success
• Ten key steps to utilize ROI for rating pull-through success
• Key steps in building a detailed model to define and direct pull-through initiatives
• Collaboration with internal and external partners for pull-through effectiveness
• Pull-through field insights
• Use of district managers to maintain pull-through momentum
• Comprehensive suite of operational, clinical, financial, digital, and behavioral metrics used to evaluate pull-through effectiveness

• Pull-through process roadmap outlining the sequence for gathering physician and staff insights, analyzing access dynamics, and aligning engagement plans
• Office-specific data analysis frameworks to develop effective pre-call plans
• Coverage-messaging frameworks showing how reps tailor access messages
• Integrated clinical + access messaging model demonstrating how clinical narrative transitions into payer-aligned value communication
• Executive narrative around invert messaging
• Methods for aligning messaging depth with meeting formats

• Executive narrative around total office call ecosystem mapping out key stakeholders
• Interview narrative around understanding office archetype to quickly inform the best TOC strategy

• Interview narratives around engagement program designs for medical assistants and biologic coordinators
• Executive narratives around specialty pharmacy integration model showing training, education, triage timelines, and coordination processes
• Interview narrative around livestream and virtual pull-through program frameworks

• Interview narratives around training sales specialists to gradually break down the entrenched perspectives of change-resistant physicians
• Executive narratives around managed care process fluency development roadmap for building payer-process understanding across field teams
• Pull-through audit metrics enabling evaluation of relationship depth, cross-role engagement, and field execution consistency

• AI use-case landscape including next-best-action engines, predictive targeting, formulary change alerts, personalization engines, and claims-driven friction identification
• Barriers to digital and omnichannel adoption
• Executive narratives around adopting emerging technologies
• Interview narratives around training sales specialists to forge trust and credibility
• Insights and narratives around fine-tuning sales specialists’ relationship skills
• Framework showing how reps earn a place on “speed dial” or favorites lists inside the office through consistent support, follow-ups, and value delivery

• AbbVie’s pull-through and patient support for SKYRIZI
• Visual overview of key role responsibilities mapped to capability areas
• Illustration of core pull-through components
• Central hub model (“SKYRIZI Complete”) highlighting integrated prescriber, payer, pharmacy, and patient-support components
• AbbVie’s field reimbursement support structures
• Inventory of prior authorization (PA) and reimbursement toolset
• Nurse ambassador and specialty pharmacy integration model showing touchpoints that improve onboarding and persistence
• Affordability and financial-assistance mechanisms designed to reduce patient cost barriers and support therapy continuity
• Lifecycle coverage expansion framework illustrating how guidance adapts to new indications and benefit structures

• Role responsibilities mapped to key capability areas
• Merck’s full-spectrum access and pull-through engine for KEYTRUDA
• Merck Access Program (MAP) central hub model
• MAP as the “one-stop / central hub” for intake, coverage, and financial support
• Benefit verification and coverage guidance for KEYTRUDA
• Prior authorization (PA) support tools
• How Merck helps HCPs overcome denials with structured appeal resources through MAP
• Simplifying financial planning for patients with co-pay and assistance support
• Reducing administrative friction with MAP-based support for claims, coding, and case management
• Merck access program (MAP) for KEYTRUDA: Coding and billing
• Field reimbursement manager (FRM) support model
• Publicly observable indicators for large-scale pull-through performance impact
• Step-by-step reconstructed KEYTRUDA pull-through workflow