Pricing and reimbursement are high on the medtech executive agenda this year. In Deloitte’s 2026 Life Sciences Executive Outlook, 37% of medtech leaders identified these areas, along with contracting and access, as a key focus for the year.1
It’s easy to see why.
Getting reimbursed is taking more time and getting more complicated than ever. And value-based contracts tying payment to outcomes need more tracking and modeling than traditional contracts. But what happens these new capabilities have to be delivered on infrastructure built for the previous commercial environment?
The gap widens with every delayed contract, manual reimbursement, and slow access to pricing data.
The Backoffice Is the Bottleneck
While medical device and diagnostics companies don’t necessarily need to modernize every legacy system, they can help close the gap between what the business needs to do and what the infrastructure can support. PwC points out that, across medtech, data that stays locked in silos and constrained by legacy IT systems, limits visibility and slows decisions.2
Three areas are especially important to bring the infrastructure back up to speed:
Contract modeling. Value-based and risk-sharing agreements require the ability to model different contract terms against outcomes, utilization, and financial data. If the data needed to do that is fragmented, it slows the process and can put teams at a disadvantage during negotiations.
Data exchange. Coverage determination, prior authorization, eligibility, and claims adjudication depend on timely data exchange between manufacturer systems and other organizations. Fragmented or legacy infrastructure can get in the way of that exchange, with a direct impact on negotiation.
Reimbursement workflow automation. Manual reimbursement processes are slow and difficult to manage consistently. Claims, appeals, and coverage exemptions all require repeatable processes, especially as reimbursement requirements become more complex. The workload is already significant: the AMA reports that prior authorization consumes and average of 13 hours of physician and staff time each week, and 40% of physicians employ staff dedicated exclusively to prior authorization.3
The infrastructure doesn’t have to do the work of the market access team. It does have to give them what they need to do it.
The Checklist: Can Your Infrastructure Keep Up with Market Access?
A good place to start is to focus on the work itself. Ask the people doing it where they have to wait, where they have to leave one system for another, and where they still fill in the gaps themselves.
Then check:
- Can we model a new contract scenario without pulling data together by hand?
- Is the data used for pricing and contracting connected to our contract management environment, or are people moving it between systems?
- Do reimbursement workflows follow a documented processes, or do they depend on individual knowledge and manual steps?
- Could we support a new contract or market entry with the environment we have today, or would IT need to build something first?
- If a critical reimbursement or contracting systems goes down, do we know how long it will take to get it back?
- Does our data governance process give us the data you’re being asked to provide?
How many boxes did you check? If you left some blank, those gaps may already be slowing pricing, reimbursement, and market access, or they may be your next bottleneck as the business needs your systems to do more.
Market Access Isn’t Waiting for IT
Companies can’t afford to treat IT infrastructure modernization as a background project. It can push infrastructure further behind the business. That just means that teams will find more ways to work around it, with temporary fixes that have a way of becoming permanent. Then, support continues to be needed for manual processes, disconnected systems, and integrations, all while IT is still has to move the business forward.
That gap is already reflected in technology investments for life sciences. KPMG found that only 59% of life sciences leaders say their technology investment decisions usually result in valuable outcomes, 13 percentage points below the average across industries.4 The problem gets worse as the commercial model gets even more sophisticated. Because a system that was good enough for yesterday’s processes turns into another workaround for the next contract, another integration for a new data source, or more manual work as reimbursement requirements change.
Get the Infrastructure Back Up to Speed
If pricing, access, and reimbursement are demanding more of your IT environment, the first step is to find out where it’s falling behind. NexusTek’s team of infrastructure specialists helps medical device and diagnostics companies assess the infrastructure behind their critical business operations, identify gaps across systems, data, security, and resilience, and build a practical path to modernization.
You don’t need to replace everything to ensure that the technology behind your infrastructure can support where the business is going next.
Learn more. https://www.nexustek.com/contact-us
Sources
1. Deloitte, 2026 Life Sciences Outlook, December 2025
2. PwC, Next in medtech 2025: Prepare to win in the future of health, October 2025
3. AMA, AMA survey: Prior authorization reform pledge falls short with physicians, May 2026
4. KPMG, KPMG Global tech report 2026: Life Sciences, May 2026