Pharma and Payers – Building Better Relationships
Pharma and Payers – Building Better Relationships
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Changes in the healthcare landscape have put payers (public and private) under mounting pressure to reduce the cost of care, and given them much greater influence over market access to new medicines.
In this new environment, regulatory approval of new drugs no longer guarantees favourable pricing and formulary placement. Instead, payers focus increasingly on value to determine pricing and access.
Drug developers need to understand the value review process, and adapt their organisation to engaging payers early in the journey. More profoundly, pharma companies must find ways to evolve their current transactional, and even adversarial, relationships with payers to more collaborative ones. After all, Pharma and payers share the same ultimate goals – to lower costs and improve care.
This new report helps Pharma and payers build a “win-win” relationship; by understanding each other’s needs, and by exploring new opportunities for collaboration.
This extensive report includes a wealth of information and tools that empower Pharma and payers to work together more effectively, with the ultimate goal of offering patients access to life-saving drugs, biologics, and vaccines.
After painting a detailed picture of the current environment (including explaining regional payer systems, and key factors driving change), the report offers a fascinating exploration of “what payers want”. You’ll learn about the primary ways in which payers are measuring outcomes (e.g., QALY, CER, pragmatic clinical trials), and discover best practices in resource allocation, organisation, communication, and accountability.
The report includes real case studies of successful pharma-payer partnerships (such as risk-sharing agreements, clinical outcomes studies), and draws on expert opinions and advice from more than a dozen of the world’s foremost thought leaders and executives in this space.
Key Report Features
Who Should Read This Report?
Key Questions Answered
Expert Views Include:
“It is no longer simply about drug cost but total cost of care to demonstrate a product’s value. Pharma is beginning to understand that.” Dr. Marcus Wilson, vice president, WellPoint, HealthCore Inc
“If drugmakers haven’t got the relevant health economic data together to support the price of a new drug then it’s never going to float.” Michael Morgan-Curran, director, mHealth Diabetes, GSMA; director/owner, MM-C Innovative Solutions
“Each payer is different and to create and maintain long term mutually beneficial relationships, pharmaceutical companies must understand a payer’s environment, the way they work, their needs and drivers.” Elliot Rosen, managing director, Accession Healthcare Consultancy
Table of Contents
for Pharma and Payers – Building Better Relationships
1. Executive Summary
2.1. Payers: who’s who
2.2. US payers
2.3. European payers
2.4. Payer organisations in the UK (England and Wales)
3.1. Rapid growth of high-priced biologics and specialty drugs
3.2. A shift from volume-driven contracts to value-based pricing
3.3. Patient non-adherence: a costly problem
3.4. Payers demand real-world data
3.5. Health economic data: is it good enough for payers?
3.6. Patient power
4.The drug manufacturer conundrum
5.The changing drug manufacturer-payer relationship
6.What payers want
6.1. Measuring health outcomes
6.2. QALY and ICER
6.3. Comparative effectiveness research, pragmatic clinical trials and adoptive licensing agreements
6.4. Improving market access via adaptive licensing
6.5. Market access agreements: health outcomes and risk-sharing schemes
6.6. Innovative US drug manufacturer-payer alliances and partnerships
6.7. Building better relationships
7.The new drugmaker-payer relationship
7.1. HTA and value-based pricing are here to stay
7.2. CER is becoming the new normal
7.3. Quality of economic modelling and health outcomes data is vital
7.4. Cost of a drug vs cost of care
7.5. Best-price frameworks
7.6. When to approach payers
7.7. Moving From transaction to collaboration builds trust
7.8. Sharing and exchanging patient data
8.Opening new communication channels is essential
8.1 Create an environment of accountability
9.Moving forward together
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This report is published by FirstWord Pharma
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