Welcome to Pain in the Access
Connecting value, access, and evidence to business strategy in pharma
Sitting here in 2025, it is incredible to think how far the biopharmaceutical industry has come in the last 30 years. Many forms of cancer are now treatable, rare and ultra-rare diseases are getting approved therapies, GLP-1s are upending weight management, and we can now cure a chronic disease like hepatitis C. And the list goes on!
But despite these advances, there are also many headwinds for pharma right now. Thirty years ago, the main challenge for manufacturers was winning regulatory approval. Today, getting a drug approved is just the first step. Payer coverage, pricing pressures, and geopolitics now all factor into whether drugs will actually reach patients.
That shift is what Pain in the Access will focus on. This publication is about the business of biopharma: how new therapies are getting from approval to adoption and how broader trends in regulation, competition, and technology are changing what it takes to succeed.
I’ll draw on over 15 years of experience in biopharmaceutical strategy, pricing, access, and evidence. Sometimes the focus will be on a single disease area or treatment class. Other times we’ll focus on broader trends playing out across the field. In all cases, my goal will be to bring analytical business thinking to this industry.
What you can expect here
We’ll cover a wide range of topics, but return to a few core themes along the way:
Business models: How manufacturers are testing new approaches, like bundling drugs and services
Pricing and policy: How new regulations and payer dynamics are influencing launch and lifecycle strategies
Competition: How changes in the competitive landscape are impacting business and investment decisions
Evidence: How new strategies for evidence generation are influencing drug coverage
Coverage protocols: The growing role of new product blocks, formulary exclusions, and step edits in determining market success
Technology: How new technologies like artificial intelligence and large language models are changing the way the industry operates
Nothing makes me happier than thinking about this industry and having conversations with like-minded folks. If anything here sparks a thought, I’d love to hear from you!
All the best,
John Jarvis