Progressions 2014

Navigating through complexity

  • Share
While payers may have similar business goals and needs, they can be very dissimilar in the ways they fulfill their goals and meet these needs.


The payer landscape is very complex and fragmented. Payers’ requirements differ across markets. Their attitudes vary across products and therapeutic categories. And the ranks of payers are growing as providers, large employers and others start acting like de facto payers.

In this environment, pharma companies need a strategic and comprehensive approach for dealing with payers. We suggest a paradigm call strategic payer engagement (SPE) consisting of four components:

  • Screening payers to identify the most relevant markets for a particular offering
  • Segmenting payers to customize offerings for the preferences of different behavioral archetypes
  • Sequencing, in which offerings are expanded and scaled up
  • Sustaining — the foundation underlying the other three components, which consists of building payer relationships that are high-level, collaborative and ongoing, through an urgent call to action around three elements:
    • Expanding into (customer-centric) solutions. While not all companies will choose to expand into services, it is critical that new approaches are designed to meet the needs of payers - not just to sell more drugs.
    • Developing data-driven insights and interventions. To meet the needs of payers, pharma companies need comprehensive data and analytics that cover the entirety of the patient experience.
    • Restoring trust. The most creative solutions and insightful data will go nowhere if pharma companies are not trusted. This is no longer just about doing the right thing, but rather about doing the right thing for business.

EY – strategic payer engagement

Guiding principles for restoring trust

The pharma industry, once one of the most highly regarded sectors around the world, now regularly emerges as one of the least trusted sectors in numerous surveys. The image in the public’s mind has changed — from that of the scientist in the white lab coat toiling away to develop life-saving new medicines, to one of companies that are more interested in using aggressive means to boost drug sales.

Restoring trust is perhaps the most urgent and important issue facing the industry today. The world has changed to the point where “doing the right thing” is now the same as “doing the right thing for business.” In the world of value-driven health care, data is the currency — and trust is the central bank. Without trust, pharma companies risk devaluing their own data.

So what can companies do to restore trust? We point to four values or guiding principles that companies should seek to emphasize:

  1. Transparency and openness. Communicate actions and intentions clearly in an environment where companies may be guilty until proven innocent.
  2. Patient centricity and proximity. Get closer to patients and act unambiguously in their interests to demonstrate that pharma companies live by the same values as other health care stakeholders.
  3. Proactive leadership. On trust building initiatives, first movers get the lion’s share of the credit. Don’t wait to follow the lead of competitors — be the first one out the door.
  4. Consistency. One misstep can undo years of trust-building work. Implement controls and audits to ensure consistent implementation.