How to adjust your Real World Data provision to address the real needs of payers
Drug costs are spiralling upwards and so too are frustration levels. Payers with stretched budgets are still struggling to make the case for ‘big ticket' drugs. Whereas pharma is keen to prove that higher cost drugs are justified and will ultimately save money. But are payers listening? And just how convinced are payers by Real World Data (RWD)? Is the evidence being provided matching their needs - or is it missing the point?
Real World Data: Meeting Payer Needs
offers a clear and practical assessment of the current mood regarding RWD, along with insight into what is needed to better meet payer needs and improve impact. In this revealing report, 10 senior-level European and US payers and payer influencers share their frank and honest professional views. The pros and cons of current RWD provision are covered in depth, along with thoughts on how pharma can better address payer challenges with RWD.
- A robust assessment of the trends shaping payer attitudes and levels of demand for RWD.
- Insight into the challenges facing payers when using RWD. What are their key issues and concerns? What specific factors are hindering uptake?
- A clear assessment of what payers want from RWD, including a range of views from the US and across Europe.
- New ideas and next steps for pharma, taking account of the full spectrum of payer needs, how to respond to specific challenges, and potential future scenarios to consider.
- Remove the guesswork: Gain clarity on what payers say they want to see from RWD if it is to be embraced and fully utilised. Focus finite RWD resources on addressing real needs.
- Results-oriented: Understand how to better integrate payer needs into the design and roll-out of RWD collection projects in the short- and long-term.
- Build positive relationships: Stand out from the rest by understanding the practicalities from the payers' perspective and responding with more relevant, timely and usable RWD.
- Take action: Review a comprehensive set of recommendations and find out exactly what action is required to move RWD to the next level with payers.
Why is it so important for pharma to change its Real World Data approach?
Although a handful of risk sharing schemes are bearing fruit, the industry has a long way to go before Real World Data is widely accepted and used as a matter of course by payers. Payment for performance makes sense for patients, payers and drug companies - but achieving this will not be easy whilst there is an underlying lack of trust in the evidence provided. Pharma can and must find new ways to close the gap between what payers want, what is provided, and how it is perceived. If not, following established routines for drug pricing will continue to be the easiest option.
Key Questions Answered By This Report
- How do payers regard RWD as a means of substantiating drug pricing, reimbursement and uptake?
- Are payers prepared to embrace outcomes-oriented budgeting, supported by RWD?
- What are the weaknesses in the currently available sources of RWD?
- What are the most important components of RWD for payers, in relation to drug effectiveness, cost-effectiveness, safety, budget impact and adherence rates?
- At what point in the budget cycle do payers want to receive RWD, how often, and for how long?
- How will RWD change the way market-access decisions are made by payers over the next five years?
Who Will Benefit from this Report?
- Corporate leaders looking to position their company in niche orphan disease opportunity areas
- Business development teams profiling potential acquisition or collaboration opportunities
- Research managers planning clinical research programmes
- Regulatory teams applying for and monitoring trends in FDA and EMA orphan drug designation
- Competitive intelligence professionals tracking the activity of key competitors in their field of interest
- Financial and consultancy professionals identifying investment opportunities.
The 10 experts interviewed for this report are senior payers and payer influencers based in the US and Europe. Each has significant experience of RWD and how it is being used currently. To enable them to express candid views, our experts have chosen to remain anonymous.
- US Payer 1: Pharmacy director at a US health maintenance organisation
- US Payer 2: Chief pharmacy officer and business director at a US pharmacy-benefit organisation
- US Payer 3: Manager of specialty and pharmacy contracts at US full-service health-benefits company
- US Payer 4: Clinical adviser at large US pharmacy and healthcare provider
- US Payer 5: US clinical pharmacist
- French Payer: Hospital pharmacologist with key influence on pricing and reimbursement committee
- German Payer: Budget manager, pharmaco-economic expert and adviser to the Federal Joint Committee (G-BA)
- Italian Payer: Regional payer and member of Technical and Scientific Committee (CTS) at Italian Medicines Agency (AIFA)
- Spanish Payer: Payer and pharmacoeconomic expert, adviser to the Spanish Agency for Medicines and Health Products (AEMPS) and the Inter-Ministerial Pricing Commission (CIPM)
- UK Payer: Commissioning Lead Pharmacist for clinical commissioning group in NHS England
3 key quotes:
“It will definitely increase. I think everybody is interested in it conceptually across the field. We are getting good value for the dollars we are spending, and as those dollars continue to grow dramatically, we are trying to justify what we're doing. From a management perspective, we are under a lot of pressure: drug costs go up and people don't believe we are managing.” US Payer.
“Because we can have one-year, two-year data, we are starting to look at the frequency compared with the licence ..... and affordability. We are using those data then to assess how much things are really costing us and potentially reviewing patients that aren't benefiting.” UK Payer.
“Horizon-scanning is something we have been doing for many years, but independent of the industry. And interaction, but more on access questions, market access, reimbursement and pricing - not so much on real-world evidence. It needs to be independent data from independent institutions, scientific institutions, independent databases. And if not, then we don't trust it, because it's difficult to manipulate an RCT but very easy to manipulate real-world evidence.” German Payer.
Who Would Benefit from This Report?
- Market access teams evolving payer-centric strategies
- Payer liaison specialists seeking to meet all requirements and fill gaps
- Senior leadership teams looking for a return on RWD project development and investment
- IT teams responsible for data collection, processing and access
- R&D planning trial conversion into real world data collection points
- Health economics and outcomes research (HEOR) professionals creating robust, relevant analyses