Market Access roles are being redrawn and reshaped on both sides of the Atlantic

In twenty years of recruiting into life sciences, I have watched market access, HEOR and RWE move from a niche, largely UK and EU based specialism into one of the most contested talent markets in the industry. What has changed is not just demand. It is the shape of the roles themselves, and employers who are still hiring against a five year old job spec are going to lose the candidates they need most.

The EU’s Joint Assessment Framework is no longer theoretical

The EU’s Joint Clinical Assessment framework has moved from concept to caseload. Since it came into force at the start of 2025 for new oncology medicines and advanced therapy medicinal products, the annual work programme for 2026 points to roughly 35 joint clinical assessments for new cancer active substances, 15 for ATMPs and the first assessments of high risk medical devices beginning around mid year. Orphan medicines follow from 2028, with the full scope of medicinal products in from 2030.

“For employers, that timeline matters because a single EU level submission file replaces a patchwork of national dossiers, and the PICO scoping stage now demands input that pulls together clinical, HEOR and RWE expertise earlier in the process than most teams are used to. I am fielding more briefs for HEOR leads who can operate across multiple national HTA frameworks at once, rather than specialists who understand one market in depth. That is a genuinely different skillset, and it is in short supply.”

Pricing policy is now a hiring signal in the US

On the other side of the Atlantic, the driver looks different but the effect on hiring is similar. The current administration’s most favoured nation pricing agenda, formalised through executive action earlier this year and now covering voluntary agreements with a large share of major manufacturers, links US list prices to those paid in other high income countries. The White House’s own analysis projects several hundred billion dollars in savings over a decade, and whatever view you take of the policy itself, the practical effect is that global pricing, launch sequencing and comparator selection decisions are being made earlier and by more senior people than before.

“I am seeing US organisations build out market access and pricing strategy functions that sit much closer to commercial leadership than they used to, and that want candidates who understand international reference pricing dynamics, not just domestic payer landscapes. At the same time, some of the sharpest UK and EU based market access professionals I speak to are increasingly open to US roles precisely because they already think in those cross border terms. That flow of talent runs both ways, and employers on either side who are not actively competing for it are losing ground quietly.”

RWE is getting harder to fake

The third shift is methodological rather than regulatory, and it is reshaping the RWE hiring brief more than anything else I have seen this year. Payers and HTA bodies are scrutinising real world evidence far more closely than they were even two years ago, and issues like time zero alignment, which governs how eligibility, treatment assignment and follow up are defined in observational studies, have gone from a technical footnote to a make or break credibility issue. AI enabled analytics are accelerating how quickly evidence can be generated from fragmented, multi source patient data, but that only raises the bar for the humans overseeing it, because a defensible RWE package now needs someone who can explain and stand behind the methodology, not just run the model.

“Practically, this means the strongest RWE candidates now sit at the intersection of epidemiology, data science and regulatory literacy, and there are simply not enough of them to go around. Employers who insist on a candidate ticking every one of those boxes at once are often better served hiring for the strongest core discipline and building the rest through structured upskilling, rather than leaving a critical role unfilled for months.”

What this means for hiring in Market Access, HEOR & RWE

A few things I would say to any employer building out a market access, HEOR or RWE function right now:

• Write specs for the market as it will be in eighteen months, not as it was when the role was last filled. Cross-market and cross-functional fluency is now a baseline expectation, not a bonus.
• Treat contract and interim hiring as a genuine strategic option, not a stopgap. Multinational RWD projects and JCA scoping work often need senior capacity for defined windows, and the best specialists in this space increasingly prefer that model.
• Compete on scope, not just salary. The candidates I speak to want to be closer to launch and pricing strategy decisions, not further from them, and organisations that give HEOR and RWE professionals a genuine seat at that table are winning the strongest applicants.
• Build talent pipelines on both sides of the Atlantic in parallel. US and UK/EU market access talent pools are drawing on each other more than at any point in my career, and the employers moving fastest are the ones already networked into both.

None of this makes hiring in this space easy. But it does make it more predictable than it looks from the outside, provided you are willing to treat market access, HEOR and RWE as the strategic, fast moving discipline it has become, rather than a support function you fill when you have time.

Looking for expert support in hiring within Market Access, HEOR, and RWE? 

Carrot Recruitment has built a strong and proven track record within the Market Access, HEOR, and Real-World Evidence space. Over the past three years, we’ve delivered consistently across for our valued clients across the life sciences sector. 

The majority of our assignments span the USA, the UK, and Europe with a focus on mid-to-senior level appointments.  

Notably, much of our work is now conducted through exclusive partnerships, enabling us to provide a highly tailored, high-quality service that drives long-term talent retention and business success. 

Martin Anderson

Founding Director