TFPA Discussion Paper · September 2026
A fresh, shared way to measure launch access, built as a tool for launch leaders rather than a scorecard to mark them down.
Approval dates are reported everywhere. The day a patient is first treated is measured far less consistently, and almost never on a common basis across therapies and markets. This paper sets out how we propose to close that gap, the two ways the Index is meant to be read, and, just as importantly, what it is not.
No form, no sign up. Seven pages. Every material figure referenced, and every claim about what is built and what is in development stated plainly.
Time to First Patient Access, TFPA, is the number of days between a medicine being approved and a patient actually being able to receive it, measured one market at a time. TFPA is the metric. The Global TFPA Index is the product built on top of it: a shared, transparent benchmark designed to let a launch team see its own performance and compare it, fairly, with what comparable therapies achieve in comparable markets.
It is in development, deliberately so, and it has already been shaped by the wider launch community. We would rather build it with the people who run launches than hand it to them finished.
The true event is a patient being treated. It cannot always be observed, so where a cleaner signal is missing a proxy is used, and it is labelled. A reader always knows what was actually measured.
| Grade | Endpoint observed | What it really tells you |
|---|---|---|
| A | First verified dispensing or administration to an eligible patient | A patient was actually treated. The true measure. |
| B | First hospital purchase, paid claim or recorded commercial sale | The medicine has been bought and can reach a patient. A close proxy. |
| C | Reimbursement listing or comparable administrative availability | A payer decision is in place. Availability, not yet treatment. |
| D | Announced or forecast access date | An intention, not an event. The lowest grade of TFPA evidence. |
Comparisons are made like grade with like grade. A lower grade is a prompt to go and find better evidence, not a place to hide.
Lens one
Forecast TFPA is the access timeline a team commits to before launch. Realised TFPA is what actually happens. The distance between the two could be one of the most useful management signals a launch has, and it is one that teams rarely write down. Read from day one, it turns access from a post mortem into something a team can act on while there is still time.
Lens two
Ninety days might be excellent for one asset in one market and disappointing for another. The Index is designed to compare like with like, similar therapy, similar market, similar access pathway, so a team sees not only its own number but whether that number is good. This is the facet that lets the industry define what good actually looks like, rather than each company guessing in private.
A tool, not a rod
The aim is not to judge launch leaders against an unfair ideal. It is to give them a fair mirror, and then the tools to act on what it shows.
A launch leader inherits a system they did not design: pricing rules, external reference pricing, reimbursement queues, supply realities, compliance requirements. Holding a launch in a lower price market to protect a reference price elsewhere is a considered decision, not a failure. The proposed methodology stratifies by the contextual factors that matter and distinguishes, where the evidence permits, between controllable and externally driven delay.
For most countries in the EFPIA survey, availability means inclusion on a public reimbursement list and does not necessarily indicate patient use or uptake. In the Index that is a grade C proxy, and it is labelled as one.
The full paper covers the method, the hard cases and where the Index sits alongside the BrandLaunchX platform.
Download the paper (PDF)The companion paper
Why great launches still keep patients waiting. The case for the measure, before the case for the Index.
The Index is in development, and we would value your view on where the endpoints should sit, how the grades should work in your markets, and what else launch excellence ought to measure.
