Real World Data and Evidence: Payer Insights

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Publication Date:
March 2019
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Payers have great expectations for real world data. Is pharma meeting them?

It's sink or swim time. Advancements in drug data collection methodologies and deeper understanding of what can be achieved has finally opened the floodgates on real world data (RWD). Information is coming onstream thick and fast and pharma can either become disoriented or use it to drive forward harder-hitting payer strategies. But what do payers in the US and Europe actually want to see before they dive into this exciting opportunity?

From payer liaison to data analysts to senior strategists—this report ensures everyone involved understands exactly what payers want today. Access senior payer views, in their own words, on all the key issues.

Use this report to:

  • Understand the mood: Delve into the payer mindset to understand in more detail their current thinking and concerns. The mood is generally positive—so what action is required from pharma to maximise on this?
  • Find out how payers are currently using RWD: Widescale adoption of RWD hasn't yet happened for various reasons, but some early adopters have begun utilising RWD to good effect. What are they doing and how can pharma build on this?
  • See what's missing: Dig below the surface and find out what else payers need next from RWD. For example, standardisation and common data models are useful—but do payers also expect some level of personalisation?
  • Evolve your RWD and evidence strategy: Discover a range of new ideas on how to more closely meet the needs of payers and maximise the chances of positive decisions on your drug.
  • Answer the third party question: How do specialist data analysts fit into the picture? Are payers for or against outside help from independents—or should pharma be stepping up and providing more assistance?

What to expect from this report

Yes, you have an RWD strategy and of course you're talking to payers all the time—but how much detailed insight do you have that joins these two together? This report bridges the gap, giving a timely and valuable look at what payers are thinking about RWD at this point, as well as a host of new ideas on how to help them utilise RWD more positively.

Real World Data and Evidence: Payer Insights provides exactly what you need to refine your RWD strategy for payers and achieve better results in the long term.

How did we do it?

  • We identified 7 current RWD issues causing concern for senior payers
  • We explored these via secondary research to develop 20 targeted questions put to 8 US and EU payer experts with up-to-date experience
  • We used all of this to identify 47 unique new insights
  • Insights are supported by 147 directly quoted comments

Example insight included in Real World Data and Evidence: Payer Insights

"Payers want to overcome the variety and complexity of RWD; pharma companies can assist by facilitating the development of standardised clinical data recording methods and formalisation of data capabilities in payer organisations. Payers require assistance in harnessing insights from real-world information. Hence, they value pharma's efforts to improve the reliability and credibility of RWD, which includes the endorsement of data standardisation and harmonisation initiatives to promote integrity, authenticity and confidentiality of electronic health records. Pharma can provide payers with support, sponsorship, and training in the effective use of RWD to refine their clinical and economic assessments and ensure therapies reach the right patients."

Example quote included in Real World Data and Evidence: Payer Insights

"RWE is underutilised in supporting discussions around formulary position, management and restrictions during negotiations. RWE would strengthen the case for positioning of medicines in formulary positions."

The expert panel for Real World Data and Evidence: Payer Insights

  • US Payer 1 has experience as a Pharmacy Director with responsibilities for several large national and regional health insurance clients as well as with the pharmacy benefit management (PBM) industry.
  • US Payer 2 has over 18 years' experience in the pharmacy industry (retail, hospital, long-term care and managed care) and over the last several years has worked as a Business Analyst in Anthem's upstart PBM, IngenioRx.
  • US Payer 3 has been the Chief Medical Officer at a provider-sponsored US health insurance company for the past 18 years, with responsibility for reviewing RWE for formulary placement and contracting decisions.
  • US Payer 4 is the President of a US payer organisation committed to improving outcomes and reducing costs and has over 20 years of experience within the pharmaceutical industry, including senior management roles with Merck.
  • EU Payer 1 is a Pharmacoeconomics Analyst in the General Directorate for Pharmacy and Healthcare Products, Valencia Regional Government, Spain.
  • EU Payer 2worked more than 15 years in a German statutory health insurance company, before joining several pharmaceutical companies in lead roles related to market access and reimbursement.
  • EU Payer 3 has been Head of Drug Reimbursement at a German public payer corporation since January 2001, previously holding the role of Head of Quality Assurance.
  • EU Payer 4 is a qualified pharmacist and health economist who works within the field of health economics and market access. Based in the UK, he joined the National Institute for Health and Care Excellence (NICE) in November 2016 as a Health Economist.

Why buy now?

RWD and RWE provision has reached a tipping point. Heightened levels of interest and a desire to end reliance on clinical trial data alone has created the ideal market conditions for pharma to move forward. But success is dependent on addressing lingering concerns about data quality, complexity and usability and moving into new territory. This report offers a timely insight into the payer mindset and reveals lots of ways in which pharma can better work with payers to achieve the mutual benefits offered by effective RWD provision.

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