Market access and its function in global life sciences

Market access has quietly become one of the most important functions in global life sciences. Once viewed as the final step after regulatory approval, it now plays a central role in determining how and when patients can access new treatments. As healthcare systems across the world grapple with tighter budgets, more complex therapies, and growing scrutiny on value, market access has shifted from a largely reactive, compliance-led activity to a strategic discipline that shapes how therapies are developed, priced, and ultimately delivered to patients.

Regulation is shaping opportunity

Regulation is one of the most powerful forces reshaping the market access landscape – not as a constraint, but as a catalyst for change. Globally, payers are demanding clearer evidence of value, stronger real-world data, and more transparent pricing.

In the UK, NICE’s 2022 methods update introduced greater flexibility in cost-effectiveness thresholds and new rules for rare and advanced therapies – expanding access routes but raising the bar for evidence quality. Across Europe, the EU HTA Regulation (from 2025) introduces joint clinical assessments across member states. While pricing and reimbursement decisions remain national, the regulation nonetheless demands greater coordination and consistency in evidence generation from the outset. And in the U.S., the Inflation Reduction Act has intensified scrutiny on pricing while accelerating the move towards value-based reimbursement models.

Together, these shifts are pushing market access teams to engage earlier and more strategically – integrating health economics, real-world data, and payer strategy throughout development. The firms that view regulation as a strategic framework, rather than a compliance exercise, are building the strongest and most durable client relationships.

Innovation is driving structural demand

The rise of complex medicines, especially in rare diseases and precision therapies, is reshaping how value must be demonstrated. Orphan drug sales are projected to grow from $148bn in 2021 to $300bn by 2028, around 25% of global prescription sales. Nearly half of new FDA and EMA approvals now relate to orphan or complex therapies.

These products require smaller patient populations, novel endpoints, and greater reliance on real-world evidence. Demand for HEOR, RWE generation, and payer strategy consequently continues to grow rapidly – bringing not just more work, but also rising expectations for depth of expertise, analytical capability, and international consistency.

Sustained growth supported by innovation

Global biopharma R&D investment now exceeds $250bn annually, underpinned by growth in cell and gene therapies, RNA platforms, and precision oncology. These therapies target smaller populations with complex, potentially curative outcomes, creating fundamentally different evidence and pricing challenges.

For market access firms, this means both the quantity and nature of demand is evolving. Clients increasingly expect early-stage partnership and end-to-end support that links clinical, value, and commercial strategy. Traditional models are being tested, and those who can adapt stand to benefit from sustained, non-cyclical growth.

A fragmented market at an inflection point

QPE views market access as a structurally important and rapidly evolving part of the life sciences value chain. The sector benefits from consistent R&D investment, regulatory change, and the growing complexity of evidence generation, all of which drive sustained demand for high-quality advisory and data-driven services.

Despite this, the landscape remains highly fragmented. Many firms have exceptional scientific expertise but limited scale, infrastructure, or geographic reach. Clients, meanwhile, are consolidating supplier relationships and increasingly expect integrated delivery across HEOR, RWE, and value communication.

This dynamic is creating a clear strategic opportunity: to bring together high-quality, specialist consultancies under a broader platform capable of delivering deeper insight, broader coverage, and consistent quality across markets.

Our recent investment in Initiate Consultancy reflects this conviction. Initiate’s strong scientific culture, deep payer expertise, and trusted client relationships provide an excellent foundation on which to build a broader market access platform.

At the same time, we believe there is significant opportunity to continue expanding this platform by partnering with other high-quality firms that share a commitment to scientific rigour, client partnership, and long-term value creation. We remain actively interested in engaging with consultancies across HEOR, payer strategy, and real-world evidence that could play a complementary role within a broader, scaled offering.

How QPE supports growth

QPE’s strategy focuses on supporting specialist firms with:

• investment in leadership and capability to professionalise and scale while retaining scientific integrity
• selective M&A to combine complementary strengths across HEOR, payer strategy, and RWE
• international expansion to meet growing client demand for consistent cross-market support

Having backed multiple founder-led businesses across healthcare and pharma services, QPE understands how to balance growth, culture, and scientific credibility. Our approach is collaborative and long-term, centred on helping outstanding consultancies achieve the next stage of scale while preserving what makes them distinctive.