Progressions 2014

Surveying the payer landscape

  • Share
As payers share more financial risk with other entities, providers and employers are becoming de facto payers in many markets.

To better understand the complex and changing payer landscape, we conducted a survey of US and European payer organizations and pharmaceutical companies.

Through the survey, we set out to explore four questions:

  1. What do payers want?
    We asked payers about their business challenges and attitudes as well as the evidentiary standards and methodologies that they regard as most important.
  2. How do payers see these issues changing over the next 3–5 years?
  3. What are the most significant differences between US and European payers?
    We segmented the survey responses of US and European payers and identified areas where the two diverged.
  4. How well do pharmaceutical companies understand payers’ needs and attitudes?
    We asked pharmaceutical companies to identify what they believe payers’ needs and attitudes to be and compared their answers to those provided by payers. We then identified some areas where there are significant gaps between the two.
EY - Pharma is from Mars, payers are from Venus?

We supplemented the survey with in-depth interviews with over 30 executives — representing both traditional payer organizations and other stakeholders with relevant insights — from numerous countries, including the US, Germany, UK, Japan, Switzerland, the Netherlands and France.

Some key highlights from our survey of US payers, European payers and pharma companies:

  • Payers are more focused on cost containment than on outcomes-based approaches to containing costs.
  • While prescription drugs are only about 10% of health care spending, payers see drug costs as their biggest challenge.
  • While pharma companies are generally well aligned with payers’ data needs, one area of disconnect is clinical trial data. Payers want data from comparative trials, but pharma companies are most invested in placebo-controlled trials.
  • Payers are preoccupied with implementation challenges related to health care reforms. They could use help on these matters, but they do not trust pharma companies to have the impartiality required.
EY – Attitudes toward the pharmaceutical industry
EY – Actions to build trust between pharma and payers.