Pharmaceutical companies face a market access talent gap that is growing faster than their internal development plans. The problem goes beyond hiring people. The real shortage lies in new competencies that are hard to name and even harder to build. This is the problem almost no one discusses out loud, and the framework that Boston Consulting Group proposed to address it.

There is an uncomfortable question for market access directors in Latin America: how many people on your team today have the competencies you will need two years from now?

The question touches something deeper than academic degrees or years of experience. The people who build value dossiers, negotiate with payers and present evidence before HTA agencies need to operate in a different environment: generative AI that speeds up processes, regulatory frameworks like the European JCA that raise the global evidence standard, and payers who demand demonstrated value before opening the formulary.

Most pharmaceutical organizations, both multinational and regional, operate with a dangerous answer: they do not know precisely. That uncertainty already carries a cost. It delays launches, reduces early access opportunities, increases talent turnover and pushes teams to work reactively when they should be making strategic decisions.

This article grounds the market access competencies problem, the framework that the BCG Market Access Roundtable developed and the actions that LATAM teams can take today, before the gap becomes unmanageable.

1. The problem the pharmaceutical industry has gone years without solving

In 2020, the BCG Market Access Roundtable, a forum that brings together senior market access leaders from more than 20 global pharmaceutical companies, published a direct diagnosis: there is a growing shortage of competencies and talent in market access. In addition, the Access role remains ambiguous, lacks a common nomenclature and still does not have a clear professional development standard [1].

The contrast with other functions is evident. Finance and marketing have clearer paths. There are recognized entry points, visible trajectories and better standardized skills. Market access remains harder to read. Getting in is hard. Advancing is too. And within the function, many people still lack clarity about which competencies they should develop in order to grow [1].

Why this weighs more now

Market access has moved to a strategic position within the executive agenda. According to BCG's 2019 benchmark, most pharmaceutical companies already incorporated explicit patient access commitments into their mission statements and executive leadership [2]. The role includes building cost-effectiveness models and orchestrating patient access as a shared goal across several functions of the organization [3].

That expansion demands new capabilities. The industry is redefining what market access means, but it advances more slowly in how to develop talent for that function.

The uncomfortable data point

Between 2021 and 2024, market access job postings in Europe grew 32%, reflecting the growing importance of pricing, evidence and reimbursement [4]. At the same time, leadership turnover in access functions has been high. In BCG's 2019 benchmark, most of the companies assessed had changed their market access leadership during the previous three years [2].

The combination of growing demand and high turnover shows a function under pressure. It also reveals a crisis of identity and capacity.

2. Why LATAM feels this crisis more strongly

Latin America faces the same competencies gap as the rest of the world, with two factors that make it more intense in the region.

Aggravating factor 1: Less specialized training infrastructure

Europe and the United States have more executive training programs in market access, such as the course that BCG developed with the London School of Economics, in addition to specialized certifications in HEOR, HTA and pharmaceutical pricing [2] [4]. In LATAM, that infrastructure is limited. Professionals depend on internal training at multinationals, expensive international programs or learning on the job.

The result is common: teams with good local tactical knowledge and underlying methodological gaps. They know how to operate in their market. They frequently lack enough training to adapt when global standards change.

Aggravating factor 2: The speed of regulatory and evidence change

CONITEC in Brazil already operates with evidence standards comparable to NICE. IETS in Colombia is consolidating its HTA methodology. CENETEC in Mexico is expanding its role toward medicines. Evidence standards in LATAM are converging with methodological frameworks like ISPOR, EUnetHTA and the European JCA [5].

Many market access teams in the region have not yet received formal training in those frameworks. The distance between what HTA agencies are beginning to demand and what local teams can execute is growing fast.

3. The BCG Market Access Competencies Framework: what it is and why it matters

In 2020, the BCG Market Access Roundtable published a competencies framework designed to bring order to the problem: to define which capabilities belong to the Access domain, how they connect to each other and how organizations can develop them systematically [1].

The framework avoids imposing job titles or organizational structures. It focuses on the competencies that a market access organization needs to demonstrate. Each company can split or combine them according to its context, but it must cover all of them.

The core competencies of the framework

The framework identifies six core competencies:

1. Evidence Synthesis. Integrates clinical, economic and real-world evidence into coherent value narratives that can be defended before HTA evaluators. Includes pharmacoeconomic models, systematic literature reviews and value dossiers [1].

2. Evidence Generation. Designs and executes studies capable of producing the evidence that payers need. Includes outcomes research, pragmatic trials, observational studies and real-world evidence (RWE) generation [1].

3. Pricing & Contracting. Covers pricing strategies, mechanisms such as external reference pricing, negotiation with payers, risk-sharing agreements and outcomes-based contracts [1].

4. Health Policy & Stakeholder Engagement. Enables an understanding of the political and regulatory context of each market, anticipation of health policy changes and the building of effective relationships with HTA agencies, patient associations, policymakers and opinion leaders [1].

5. Access Strategy & Portfolio Management. Connects Access with medical affairs, clinical development, commercial and regulatory functions to integrate access considerations throughout the product life cycle [1].

6. Cross-Functional Leadership & Communication. Develops the ability to lead without formal authority, communicate value to diverse audiences and facilitate collaboration among functions that often operate in silos [3].

The evolution of the framework: from 2020 to 2022

In 2021, the BCG Market Access Roundtable updated the framework to reflect new realities of the environment [3]. The traditional competencies remained valid, and advanced capabilities took on more weight:

Systemic perspective: the ability to interpret macroeconomic trends, read their implications for health policy and position access efforts within the complete ecosystem.
Digitalization and advanced analytics: the ability to use digital tools, machine learning and predictive analytics in market access decisions, from economic modeling to identifying access barriers [6].
Enterprise leadership without authority: the ability to move decisions across functions, build alignment and communicate access as a business priority [6].

4. How to apply the framework in LATAM teams: three concrete levers

The BCG framework was born for global multinationals, and its principles also serve market access teams in Latin America. It applies both to multinational companies and to regional organizations. These three levers make it possible to start without waiting for a complete transformation.

Lever 1: Diagnose the gap before investing in training

Many pharmaceutical organizations invest in training without being clear about which gap they are trying to close. The first step consists of mapping the team's current competencies against the BCG framework.

Useful diagnostic questions:

How many people on the team can build a cost-effectiveness model from scratch without external consulting? (Evidence Synthesis)
How many can design an observational study protocol that generates evidence acceptable to CONITEC or IETS? (Evidence Generation)
How many understand how external reference pricing works in LATAM markets and can anticipate its impact on the launch strategy? (Pricing & Contracting)
How many can coordinate with medical affairs, clinical development and commercial to integrate access considerations into clinical trial design? (Access Strategy)

An honest diagnosis defines the real talent development agenda.

Lever 2: Build cross-functional competencies alongside technical ones

Technical competencies, such as economic modeling, systematic reviews and dossier building, are necessary. They are also incomplete. The BCG framework gives equal weight to cross-functional competencies: cross-functional leadership, strategic communication and leadership without formal authority [3] [6].

In LATAM, where market access, HEOR and medical affairs teams often operate in silos, this gap is costly. A team with great technical capacity and little cross-functional coordination loses opportunities to influence clinical trial design, comparator selection and evidence strategy from early stages.

Investment in cross-functional competencies can include:

Rotations across market access, medical affairs and HEOR.
Early participation of market access in integrated evidence planning committees.
Specific training in value communication for non-technical audiences, such as commercial, executive leadership and payers.

Lever 3: Leverage existing global training resources

LATAM has less specialized training infrastructure than Europe or the U.S., but professionals in the region can access several global resources:

The ISPOR HEOR Competencies Framework is public and downloadable, with detailed descriptions of technical competencies and soft skills relevant to HEOR [7].
Certifications and courses from ISPOR, EUnetHTA and specialized academies are available in virtual format.
The BCG Market Access Roundtable reports, including the competencies frameworks, are published in open access on Pharmaceutical Executive.

The central challenge lies in organizational prioritization. The companies that invest in systematic competency development for their LATAM teams, with clear trajectories and continuous training, build a tangible competitive advantage.

5. Why this cannot wait

Many organizations treat the competencies gap as a medium-term problem. They expect to solve it with gradual hiring and scattered training. That reading underestimates the speed of change.

Three trends accelerate the urgency:

Trend 1: Evidence standards in LATAM are converging with Europe. CONITEC, IETS and other HTA agencies in the region watch the methodological developments of the European JCA, NICE and HAS closely. It is reasonable to expect that these frameworks will influence local evaluation criteria [5]. The teams that cannot produce evidence at that level of rigor will arrive late.

Trend 2: AI changed the speed of the game. The teams that use AI tools to speed up systematic reviews, adapt dossiers and build value narratives compress processes that previously took months [8]. Using AI without underlying methodological competencies also entails risk. The team must know what to validate, what to question and what to document.

Trend 3: Talent turnover hits those who lack structured development. The high leadership turnover in market access documented by BCG affects the retention of institutional knowledge [2]. When an organization lacks competency frameworks and clear trajectories, it loses people and also loses tacit knowledge.

The framework exists. The advantage will go to whoever uses it first.

The market access competencies crisis is already documented in the industry literature. The frameworks to address it exist. The training resources are available.

What remains is execution.

The pharmaceutical organizations in LATAM that begin today to diagnose gaps, develop talent with proven frameworks and build cross-functional capabilities in addition to technical ones, will have market access teams that are more effective, more agile and better prepared for the environment ahead.

Those that wait until the crisis is visible will lose two years they cannot recover.

At Quantus, we work with market access, HEOR and medical affairs teams in Latin America to build the capacity to demonstrate value in increasingly demanding evaluation environments. If you want to explore how to apply these competency frameworks in your organization, write to us.

References

[1] BCG Market Access Roundtable Working Group. Building Market Access Competencies for the Future. Pharmaceutical Executive. November 2020. Available at: pharmexec.com/view/building-market-access-competencies-future

[2] BCG Market Access Roundtable Working Group. Market Access: From Being to Becoming. Pharmaceutical Executive. February 2020. Available at: pharmexec.com/view/market-access-being-becoming-0

[3] BCG Market Access Roundtable. A Cross-Functional Formula: Operationalizing the Broader Role of Access. Pharmaceutical Executive. August 2021. Available at: pharmexec.com/view/a-cross-functional-formula-operationalizing-the-broader-role-of-access

[4] PharmUni. Market Access Pharma Courses: 2025 Guide. December 2025. Available at: pharmuni.com/2025/12/25/market-access-pharma-courses-skills-frameworks-real-world-applications-year-guide

[5] Quantus. Does your market access team know what Europe decided in January 2025?

[6] BCG Market Access Roundtable. A New Era for Market Access: Organizing the Function's Broader Strategic Role. Pharmaceutical Executive. February 2023. Available at: pharmexec.com/view/new-era-market-access-organizing-function-broader-strategic-role

[7] ISPOR. HEOR Competencies Framework. Available at: ispor.org/heor-resources/heor-competencies-framework

[8] Quantus. How much is it costing your team to build a value dossier without AI?