As pricing and market access decisions become more interconnected across markets and lifecycle stages, the way these functions are organized matters more than ever. This article explores the two dominant organizational models in life sciences, the trade-offs each brings, and why governance, accountability, and portfolio complexity should shape the right setup.
Why the pricing-access split has become a strategic question
Pricing and market access have always been closely connected in life sciences. While the connection exists, the cost of misalignment is now more prominent. Pricing and access decisions today are more tightly linked across markets, indications and lifecycle stages, making later adjustments more difficult.
Across our work with pharma and biotech companies at different stages of maturity, we consistently observe that organizational models which work well at lower levels of complexity begin to break down when exposed to scaling portfolios, broader geographic footprints, and external policy shifts and evolving pricing regulations that the original model was not designed to absorb. Decision speed slows, accountability blurs, and pricing and access outcomes are increasingly shaped by early assumptions that were not designed to hold over time.
This dynamic is amplified by portfolio complexity. Multi-indication products, rapid label expansions, and clusters of assets within the same therapeutic area compress timelines and tighten interdependence between evidence generation, access strategy, and price setting.
In parallel, more formalized HTA processes, including the upcoming EU HTA Regulation, require earlier and more coordinated evidence and access decisions across markets. Pricing mechanisms, such as International Reference Pricing (IRP) and Most-favored nation (MFN) considerations, further reinforce cross-market dependencies and leave less room for late price corrections.
In this environment, organizational design becomes a strategic lever rather than an operational detail. Many pharma and biotech companies are therefore re-examining a fundamental question: How should pricing and market access be organized to enable coherent decisions, while maintaining sufficient specialization and control? The answer is not one-size-fits-all. Rather, the choice of model has a tangible impact on decision speed, consistency, compliance, and ultimately value capture.
Building on recurring patterns observed across companies, we examine how Pricing and Market Access roles are organized in practice, why different models coexist, and under which conditions each model tends to work or fail. Rather than arguing for a single optimal setup, we focus on the design principles and trade-offs that matter most as complexity grows.
Clarifying the language: What does pricing and market access mean?
Given the growing strategic importance and interdependence of pricing and market access decisions, clarity on what these roles entail becomes essential. In practice, these responsibilities are not always clearly defined, and overlaps between both roles are common, as both contribute to a shared strategic objective. When ownership is unclear, organizations are more likely to experience friction and inconsistent decision-making.
Across pharma and biotech companies, pricing and market access activities are typically organized around three core roles, excluding closely related capabilities such as Health Economics and Outcomes Research (HEOR), Policy, and Public Affairs. Despite differences in reporting lines and terminology, these roles recur across companies and together cover the full product lifecycle.
| Role | Core Focus | Typical Responsibilities | Success Metrics |
| Market Access & Value | Bring HTA/payer perspective into the overarching product P&MA strategy | Develop global value proposition (incl. dossier, objection handler) and value narratives; shape HEOR priorities in alignment with access strategy; set global access objectives and frameworks; support/drive local adaptation of evidence, HTA submissions and stakeholder engagement; and define negotiation strategy and need for lifecycle reassessments | Reimbursement outcomes, breadth of access, time to access |
| Strategic Pricing | Set a global price positioning capturing asset value and lead pricing strategy across the lifecycle | Define global list/net price strategy, pricing policy and launch sequencing; provide contracting guidance; ensure compliance with pricing guidance; support local pricing decisions with defined internal pricing parameters | Value captured, protection of price integrity through adherence to internal price frameworks, and pricing coherence across markets |
| Operational Pricing | Ensure day-to-day price execution, monitoring, and control | Track list and net prices across markets; identify and monitor IRP risks; ensure effective functioning of price management systems (price database, KPIs); support affiliates in price implementation and reporting | Price accuracy and monitoring, IRP risk visibility, system reliability |
Responsibilities within all three functions begin well before launch and extend throughout the product lifecycle. Market Access & Value, for example, needs to be involved already during clinical development to bring the payer perspective into evidence and value planning, while pricing and access assumptions continue to evolve as portfolios, indications, and market conditions change.
In addition to these three core functions, several enabling capabilities support these roles across the lifecycle. HEOR plays a critical role in generating clinical and economic evidence that supports both access and pricing decisions. Depending on the organization, HEOR may be integrated within the Market Access and Pricing function or sit with Medical or Evidence generation functions. Policy and Public Affairs play a similar enabling role, monitoring and interpreting regulatory and policy developments, engaging with relevant stakeholders, and shaping the context within which pricing and access strategies are developed.
Organizational models observed, and why different models coexist
Across the pharma and biotech industry, there is no single “ideal” way to organize pricing and market access. Instead, companies adopt different models reflecting different realities: the need for faster decision-making vs. tighter control, the size and complexity of their portfolio, or the maturity of their organizational and governance capabilities. As organizations scale, portfolios become more complex, and external policy and market changes reshape the rules of pricing and access, many companies revisit and adapt their P&MA setup over time.
Despite this diversity, most industry setups can be grouped into two recurring archetypes or models, each defined by how responsibilities and decision rights are distributed rather than by formal reporting lines.
The models below primarily reflect global and regional P&MA design. At the country level, organizational setups may vary depending on market size, maturity, and local governance requirements.
Model | Description | Design logic | Advantages | Drawbacks | Typical context | Typical break point |
| Model 1: Integrated Pricing & Market Access roles | Strategic Pricing and Market Access are fully integrated in one role per asset/ therapeutic area (TA) – both under a single leadership | Maximize speed and coherence in lower-complexity settings | Fast decision-making, increased consistency per asset/TA, clear ownership, broader cross-functional development opportunities | Limited specialization, difficult to scale as portfolios and governance demands grow | Small, mid-size companies, early-launch environments, focused portfolios | Portfolio expansion and growing cross-asset /cross-market dependencies that require more formal governance |
| Model 2: Separated Pricing & Market Access roles | Strategic Pricing is a dedicated role, separate from Market Access – also with asset/TA responsibilities split within functions and both under a common leadership | Enable functional specialization, clearer separation of decision ownership and consistent internal pricing guidance across the portfolio | Strong pricing expertise, clearer specialist roles, greater portfolio-level consistency across assets and markets | Increased handovers, slower cross-functional alignment and decisions | Large mature pharma with broad portfolios | Situations requiring tight and real-time coordination between Pricing and Market Access across interdependent indications or assets within the same therapeutic area |
Reporting lines may vary – whether asset- or therapeutic-area driven, regionally structured, or globally centralized – and the level at which pricing and access converge differs across organizations. In some cases, integration occurs at the asset or geographic level, with specialized teams underneath; in others, they remain largely separated and converge only at senior executive level. Regardless of structure, the underlying design question is how pricing and access decisions are orchestrated across the organization.
Beyond the choice of overall P&MA model, companies also face a practical question: Where should operational pricing responsibilities sit? In practice, this often evolves as organizations grow in size, portfolio breadth, and geographic reach.
- Strategic and operational pricing combined: In smaller organizations with limited portfolios or geographies, operational pricing is often handled by the same role responsible for strategic pricing, separated from market access (applies only to Model 2 companies). This works where the operational workload remains manageable, allowing strategy and execution to stay closely aligned without adding unnecessary organizational layers.
- Operational pricing centralized in a dedicated CoE: As portfolios expand across multiple assets, therapeutic areas, or regions, many companies centralize operational pricing in a dedicated CoE. This setup could be well suited to organizations that need to track a high volume of products across multiple TAs and markets, as it supports consistency and IRP risk monitoring. In some organizations, often for historical or structural reasons, these responsibilities may sit within Finance.
- Operational pricing within a global P&MA hub: In large, highly diversified companies, operational pricing may sit within broader global P&MA hubs. Central CoEs exist to carry not only operational pricing responsibilities but also to define pricing frameworks, methodologies, and governance standards across therapeutic areas and business units. Asset or TA teams retain ownership of pricing and access strategies, while local teams execute. This setup supports alignment across therapeutic areas and business units but requires strong interfaces to avoid distance between CoEs and market and business realities.
Recent pricing reforms, including MFN-type considerations, have further reinforced the need for tighter coordination between pricing, access, and finance. Even in organizations without formal global hubs, such pressures often lead to the creation of cross-functional working groups to assess cross-market implications and manage trade-offs more explicitly.
When a dedicated strategic pricing role becomes critical
For companies operating in therapeutic areas with multiple interdependent assets or indications, the relevance of a distinct strategic pricing role becomes significantly stronger. In these settings, pricing decisions are rarely confined to a single product or indication. Shared comparators, treatment sequences, and payer reference points mean that a pricing decision taken for one asset can shape expectations for others, even when evidence or access outcomes differ.
Without an explicit portfolio-level view, asset-by-asset pricing optimization can erode portfolio value through unintended consequences across assets. In this setting, a TA-level strategic pricing role can help maintain coherence across assets by aligning price ambition, sequencing, and defining key guardrails, while allowing asset/indication-specific roles to retain ownership of strategy execution and stakeholder engagement.
Such orchestration is not required in all contexts. For focused portfolios or single-asset companies, a separate strategic pricing role may add unnecessary complexity. However, as interdependencies across assets and indications grow, relying on coordination efforts between parties becomes increasingly risky.
What matters more than structure: governance and accountability
Across the organizational models identified, a recurring pattern emerges: Performance is driven less by reporting lines than by governance. Many of the challenges observed in practice, such as slow decisions, inconsistent guidance, or execution gaps, stem not from the chosen structure itself, but from weak coordination mechanisms, unclear decision rights and ownership, and misaligned incentives across teams.
Three design principles consistently differentiate effective P&MA setups:
- Clear accountability for the overall P&MA strategy: Regardless of the structure, there must be explicit ownership of how pricing and access decisions come together across the lifecycle, even when responsibilities are split across different roles.
- Functional specialization where pricing risk extends beyond individual assets: Operational pricing, in particular, benefits from separation once portfolio complexity and IRP risk increase.
- Explicit portfolio-level orchestration when interdependencies rise: In multi-indication or multi-asset therapeutic areas, pricing trade-offs cannot be left to informal coordination efforts but must be actively managed to avoid decisions taken for one asset undermining value elsewhere.
Implications for P&MA leaders
Choosing the right pricing and market access setup is not a one-off structural decision. It requires periodic reassessment of roles, decision rights, and governance mechanisms as portfolios broaden, and pricing and access decisions carry greater cross-market consequences. In many cases, structural evolution is triggered not only by portfolio growth or geographic expansion, but by external shifts, such as policy changes or pricing reforms, that expose weaknesses in existing setups.
Organizations that proactively revisit their P&MA design, rather than only once coordination starts to break down, are better positioned to maintain decision speed, protect price integrity, and sustain access over time. In practice, this often means investing less energy in redrawing organization charts and more in clarifying accountability, strengthening governance forums, and aligning incentives across pricing and market access.
At the same time, the way P&MA teams operate is changing. More advanced analytics and digital tools, from real-time price tracking to scenario modelling across markets, are becoming part of day-to-day operations. Rather than simplifying organizational choices, these developments reinforce the need for a clear role definition and effective cross-functional collaboration, regardless of the underlying model.
Ultimately, pricing and market access organization design is a leadership choice with long-term consequences. As complexity grows, the question is no longer whether structure matters, but whether it actively supports coherent decision-making and value capture over time.
To explore how your current P&MA setup aligns with your portfolio ambition and pricing and access exposure, reach out to our experts.
