How do you solve a problem like the GVD?

Let’s face it, Global Value Dossiers (GVDs) get a bit of a bad rap. Too long, too dry, a tick box exercise, a data dump that nobody will use. And yet they remain a market access mainstay. Every product approaching launch needs a clear narrative and supporting evidence package, and this has evolved very little over the years.

But why is that? Those of us working in market access come up with innovative solutions to sticky problems all the time. So why has the GVD not moved with the times? Perhaps because, despite the grumblings, they do meet most of the needs of most stakeholders. However, there is always room for improvement. So, how can we create a modern-day GVD?

What makes a great dossier?

Primarily, GVDs serve to communicate the value of a product to payers and provide all the necessary information to allow local adaptation of the content into HTA submissions. They comprise an executive summary to highlight the value story, and chapters outlining the disease burden, current treatments and unmet needs, product information, and the clinical, humanistic and economic value of the product. Sound familiar?

If they’re written well, then they shouldn’t be too long, and if they’re written really well, then they shouldn’t be dry. The value story will be woven throughout the dossier like a red thread, keeping the reader engaged and on message.

A quick google search reveals more than a few articles outlining how to develop a “best-in-class” GVD. So much so that even AI can pull together a convincing list of top tips for making your GVD a success – such as:

• Know your audience
• Keep it concise
• Structure it like a pro
• Make it easy to use (and hard to misuse)
• Add a dash of personality
• Make it a living document

Nothing revolutionary there. And if executed well, following these tips will deliver a GVD that is concise, interesting, and supported by data. All of which would appear to meet the needs of market access teams across various territories and payer archetypes.

So what’s going wrong?

If everyone knows how to make a “great” GVD, then why does it still have a reputation as the kitchen sink of market access deliverables? Knowing the theory is clearly not enough.

In our experience, GVDs are often associated with a few key issues:

• Too slow. Often they’re received after HTA submission preparations (and local dossier writing) have started. That’s too late for anything more than a check of messaging and key data by the local teams.
• Not “living” enough. New data comes out, and a GVD update is commissioned. But again, it takes time for the GVD to catch up. And the affiliates need the data quicker than that
• Too much kitchen sink. Updates are included. Then another. Then another. A new data cut. New supporting impact data. Some local economic models add robustness to the initial cost-effectiveness model. All good stuff. But nothing is removed. And you end up with a 400-page document that’s hard to use and has lost its narrative
• No story or strategy. Strategic communication is challenging. It requires bravery and a keen eye on what to leave out. And an understanding of how to frame and support what you put it. It’s an uncommon combination, and many agencies who claim to be good at it, simply aren’t

We have conversations about these issues with prospective clients a lot. With people who are wanting to do a good job and support their teams but hampered by time, or budget, or just the headspace to sit down and refresh the narrative and evidence package included based on the current commercial landscape. Maybe that’s you?

And it’s a conversation we’ve been having more and more frequently with clients who are frustrated with the traditional GVD structure and believe it can do more. We’ve discussed short GVDs, targeted GVDs, interactive GVDs, even a complete overhaul of the typical GVD structure. There is an obvious desire for something better than what’s gone before. Something that is well-structured, short, easy to navigate and pull content from, and that tells a clear value story.

What’s the solution?

Well shorter GVDs, certainly. That will make them quicker to write and update. We’re working on some examples at the moment with bold clients who want to go succinct, or want to look to structure the document around the sorts of questions affiliates and payers will ask.

Another way to evolve is to look at the companion deliverables that go alongside it. Market access teams need various ways to access and digest the necessary information. A GVD slide deck is a useful tool but only helps users consume the GVD content in a more visual way. An objection handler goes a bit further to support local affiliates in responding to potential payer queries, but doesn’t always tie back to the GVD content.

With the right companion deliverables a GVD could fulfil its potential to communicate product value in an accessible and engaging way, while detailed appendices and supporting documents could provide the navigation, payer perspectives and visuals to bring it to life.

A GVD toolkit could look something like the below, providing a variety of ways to navigate the complex data, and attempting to address payer questions head-on:

• Value narrative: a topline summary of the value story for anyone short on time. Key messaging, succinctly delivered
• Strategic GVD: structured around the value messages to ensure a targeted presentation of the key supporting evidence. Under 100 pages
• Regulatory and access appendices: JCA/HTA-ready detailed summaries of the clinical and economic evidence, ready for affiliates to copy and paste into their submissions; Excel-based country-specific summaries of treatment guidelines/pathways, epidemiology and economic and humanistic burden; PICO assessments
• Quick reference guide: Frequently asked questions with a short response and signposting to where to find the information in the GVD or regulatory appendices
• Value story slide deck: visual summary of the value story, for presentations
• Objection handler: Potential payer queries and HTA-ready responses. Word format for easy copy and pasting into in-country written negotiation documents

What about AI?

It’s a fair point. AI is changing the landscape fast. And it can write quickly. Our experience is that it has great promise in dossier writing, particularly at the pace the technology is moving at.

Our redthread view though, is that you will – for the foreseeable future – want humans in the loop. Humans to parse through your data and select what’s most compelling. Humans to create and tell your story. Humans to understand what resonates with other humans. And – ultimately – a human to oversee the process.

AI has its place and will adapt fast. And it’s certainly helpful for supporting many of the contributing processes for dossier development. To what extent AI writing solutions are the future though, remains to be seen

In summary

Whatever your chosen approach, ultimately, the future of GVDs lies in their ability to grow and adapt, providing market access teams with various ways to access and digest the necessary information, and addressing payer questions head-on. As part of a holistic suite of deliverables, GVDs can continue to be valuable tools in the ever-changing landscape of market access.

If any of these issues resonate with you, or you’d like to hear more about how we can support you solve your GVD problem, drop us a note at hello@redthreadmarketaccess.com