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Pulling the Data Puzzle Together: Being Payer-Centric

Product Code:
Publication Date:
April 2017

Mapping data with payer needs. How to solve the data puzzle. 

Everyone is talking about data. What’s being collected; how robust is it; what does it prove; who should be told? From the all-important payer perspective, the ‘data puzzle’ is a complex one to solve. Payers want to see data on safety, efficacy, effectiveness, affordability and patient population - but in varying degrees.  The disparate payer population is demanding more and better evidence, so what action plan is needed?  Find out how drug companies should respond to payer nuances and evolve targeted data strategies that actually succeed.  

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Report Overview

Pulling the Data Puzzle Together: Being Payer-Centricspecifically looks at the growing importance of data in meeting the evolving needs of payers. Based on interviews with 8 senior market access and payer strategy experts from across the pharma industry, it reveals the datasets of most value, and offers practical guidance for building a payer-centric data strategy.  

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Executive Summary

Due to the industry-wide shift in healthcare from a volume-based system to a value-based system, as well as the need to contain rising healthcare costs, efforts to generate data must be expanded to meet not only regulatory data requirements, but also payer data requirements. Indeed, data is key to achieving market access in today’s competitive market landscape and will remain vitally important in the future. Although data is available and accessible, it also comes in a mixture of structured and unstructured forms and often from disparate sources. It is now a question of which datasets are relevant and how these can be optimised to create effective and sustainable payer solutions. This report analyses the data needs of payers and how pharmaceutical companies can put the right pieces together to form a comprehensive body of evidence that demonstrates the value of drugs. Throughout this report, answers to the following questions are discussed:

  •  What are the data requirements of payers? Payers require information on health outcomes and the economic profile of drugs, data which are generally beyond what randomised control trials (RCTs) can provide. The common data types that payers search for in the value proposition of new medicines are discussed in detail. 
  • How has the proliferation of data influenced the pricing and reimbursement decisions of payers? The industry is seeing an increased application of real-world data. This report tackles the degree of influence of non-RCT data on the decision-making process of payers and healthcare authorities, and the need to have an eye for quality and a strong focus on payer priorities when handling real-world data.
  • How can payer engagement shape evidence? Some of the objectives in payer engagement include identifying the data needs of payers, integrating the payer perspective into various clinical and market access activities, and shaping a payer-centric approach to strategy development. The timely and necessary application of payer archetypes and payer advisory boards are discussed in the report.
  • How can data gaps be identified and filled? RCTs do not provide all of the information that would enable payers to make sound pricing and reimbursement decisions. This leads to major gaps in evidence, wherein different types of payer uncertainties tend to emerge, creating barriers to patient access. This report outlines the different types of innovative contracting schemes that help reduce payer uncertainty and promote patient access to new medicines.
  • Who should put the pieces of the data puzzle together? As payer data requirements evolve and data types expand, the data competence of pharma companies must also advance. The growing significance of the Market Access role, as well as of emerging novel named job roles that are payer-focused, are highlighted here.
  • What are the key factors that facilitate the completion of the data puzzle? An orientation away from volume and towards value and a need to address the specific needs of payers for market access purposes necessitate a cultural shift towards payer-centricity and certain changes to the traditional business model of pharma.
  • How can the data puzzle be enhanced and continually improved? A long-term and holistic view of value will enable pharma companies to continually respond to the changing data needs of payers, respond to their evolving roles, and ultimately build towards a sustainable future for healthcare delivery where the needs of payers, patients, pharma and other stakeholders are all met.
  • To provide high value input to the above questions, eight professionals with expertise in Market Access, Payer Strategy, Payer Marketing, HEOR Management, Customer Experience and Healthcare Strategy were interviewed for this report

©Doctor’s Guide Publishing Limited. This executive summary is provided for commercial evaluation purposes only. It can be shared with colleagues for this purpose but cannot be reproduced, extracted or published without the express permission of the publisher.

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Report Features

  • A breakdown of the 5 most common payer archetypes and their various goals and data needs. Also discover the subtle but important differences between European and North American payer data requirements.
  • Clarification on the datasets payers are most actively seeking and their significance within the decision-making process. What is the optimum balance of clinical, commercial and patient outcomes data?
  • Insight into building a case for RWD applications including data components and targeted objectives for payer engagement.
  • Expert views on how pharma should pull the data puzzle together including the key people and roles required, core data infrastructure requirements and the ideal company culture.
  • Exploration of the relationship between payer-centricity and patient-centricity. Are these interdependent or mutually exclusive?

Download now – and don’t get left behind as the payer landscape shifts.

Key Benefits

  • A joined-up plan: Understand how to better integrate payer needs into the drug commercialisation process and market access strategy.
  • Improved market access: Use payer archetypes to segment your data strategy and provide a more coherent way forward.
  • Get ahead of the pack: Engage earlier in the payer communication process with relevant, timely and targeted evidence provision.
  • Overcome concerns: Meet payer needs more closely and offer reassurance (before they attempt to fill the gaps themselves) with the information that addresses their challenges.
  • Up your game: Discover best practice for frameworks and payer advisory boards, identify evidence gaps and establish a road map and action plan.
  • Upskill your team: Understand the company roles, responsibilities and skill sets needed to drive forward a sustainable, payer-centric data strategy.

Put payers at the centre of your data strategy. Download this report to find out how.

Why is data the key to payer engagement?

When game-changing drugs are not getting reimbursed, improving market access becomes the most important goal – not just for pharma but ultimately for patients too. Today data sits at the very core of market access and payer market agreements, and pharma must utilise its power more effectively to make a difference. That means converting data volume into value, improving data quality and relevance for payers, and making a robust case for every drug. Yes, the balance of cost savings and patient outcomes is a delicate one, but when outcomes based agreements are the ‘new normal’, data is the key to fulfilling promises and achieving long-term success.

Find out how to use data to engage payers. Download this report now.

Key Questions Answered

  • How is real world data impacting payer priorities and decision-making?
  • Do RCTs still have a place – and if so, how does this fit with what payers want to see?
  • Which economic and health data types are payers most interested in?
  • What should your payer-centric data strategy look like?
  • Which data gaps must be filled to reduce payer uncertainty and improve patient access?
  • How is data shaping and evolving key roles within market access and beyond?
  • How should clinical, commercial and economic data be put together to resolve the payer data puzzle?
For the answers, click here.

Expert Views

The experts interviewed for this report are responsible for market access, payer strategy and evidence generation in leading pharma and healthcare consulting companies.

  • Mike Bellis: Partner, PEN CX (Formerly Customer Experience Lead for Pfizer Europe)
  • Roy Bentley: Independent Consultant, Market Access & Healthcare Strategy
  • Charles Hampsey: Director, Payer Marketing, Daiichi Sankyo
  • Anders Holmen Møller: Global HEOR Manager, LEO Pharma
  • Klaas Postema: Senior Director, Market Access & Pricing Generics, Teva
  • Mete Saylan: Market Access Director, Bayer
  • Nilhan Uzman: Strategic Payer Evidence Specialist, Roche
  • Simone Wyss: Head, EUCAN GI Market Access, Takeda

3 Key Quotes

“Some payers are more experienced now in that they can understand models and data provided by pharma. There are more experienced and well-trained payers who are able to discuss the data provided. Some of them have the intention to make their own research to understand the disease condition and potential cost/benefits.”
Mete Saylan: Market Access Director, Bayer

“Market Access is expected to become the foundation of the pharmaceutical company in the future and replacing the two concepts – Marketing and Medical – that are driving company growth today.”
Nilhan Uzman: Strategic Payer Evidence Specialist, Roche

“We have used archetyping for several years now, and so have other major companies, but never before has it been more applicable.”
Anders Holmen Møller: Global HEOR Manager, LEO Pharma

Stay up to date with the latest expert thinking and order today.


Who Would Benefit from This Report?

  • Market access teams evolving payer-centric strategies
  • Brand marketing departments seeking new ways to edge ahead
  • Senior leadership teams looking at technology and role development
  • IT teams responsible for data collection, processing and access
  • Payer liaison specialists seeking to meet all requirements and fill gaps
  • R&D planning trial conversion into real world data collection points
  • Health economics and outcomes research (HEOR) professionals needing more robust, relevant analysis

Order now and start planning your payer-centric data strategy

Content Highlights

  • Executive Summary
  • Research Methodology
    • Experts interviewed
  • The rising significance of evidence on value
    • From volume to value
    • The availability of data
  • Data availability and decision-making
    • Key Insights
    • Data’s influence on payer decision-making
    • Data’s influence on healthcare authorities
    • Guaranteeing the quality of data
  • The data components of evidence
    • Key Insights
    • Evidence expansion: regulator vs. payer
    • The expanding number of RWD applications
    • The data types that payers seek
      • Health outcomes and drug effectiveness
      • Affordability
      • The patient population
  • Meeting data objectives during payer engagement
    • Key Insights
    • Identifying the data needs of payers
    • Integrating the payer perspective
    • Tailoring the communication of data to the individual payer
  • Completing the data puzzle with innovative contracts
    • Key Insights
    • Innovative contracting solutions
    • Opportunities in innovative contracting
  • Key factors to pull the data puzzle together
    • Key Insights
    • Data capabilities and infrastructure
    • People, positions and partnerships
    • A culture of payer-centricity
  • Enhancing the data puzzle
    • Key Insights
    • Patient-centricity at the heart of payer-centricity
    • A long-term, holistic approach to value
    • Prevention
  • Conclusion

This critical intelligence is available for immediate download — order your copy now

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