US market access organizations find themselves at a pivotal crossroads. The biopharma industry continues to generate transformative therapies at an unprecedented pace, yet the environment in which those therapies must achieve commercial success has never been more complex or unforgiving. Policy volatility, payer consolidation, and tightening formulary controls are redefining the rules of engagement, even as the bar for patient access continues to rise.
Against this backdrop, market access functions face a dual mandate: they must protect and grow the commercial value of existing assets while simultaneously preparing for a wave of highly specialized, often high-cost therapies that demand sophisticated, proactive access strategies. For many organizations, meeting this mandate will require a fundamental rethinking of how their access functions are structured, resourced, and led.
To understand how US market access leaders are navigating this challenge — and to identify what separates those who are succeeding from those who are not — the Blue Matter team conducted a series of one-on-one interviews with senior leaders from 18 biopharma companies between February and April 2025. These interviews ranged from 30-60 minutes each.
Participants included Executive Directors, Vice Presidents, and C-suite members from a diverse group of companies including:
- Five large organizations (annual revenue greater than $15B, more than 150 pipeline assets)
- Nine mid-size firms (annual revenue $1–15B, 20–150 pipeline assets)
- Four emerging companies (annual revenue under $1B, fewer than 20 pipeline assets).
Our conversations centered on a single organizing principle: what does it take to become a Best Practice Organization (BPO) in US market access?
