Understanding Payer Decision-Making is Key for Future Growth in Pharmaceutical Industry

The U.S. Supreme Court’s ruling this week in support of the Affordable Care Act was good news for the health insurance industry. If the court had ruled against the government, insurers were at risk of losing millions of customers.
Instead, payers will continue to grow as the number of insured Americans increases. For the pharmaceutical industry, this means more of its top-line growth will flow from payers and it will be critical for organizations to understand not only the different payer segments but also what drives payer decision-making.
To help pharma leaders navigate this new landscape, research and consulting leader Best Practices, LLC conducted a research project to identify what market research approaches are most effective and innovative for understanding payer needs and decision-making. The wide-ranging study also identifies what market research approaches are most effective for understanding payer contracting activities & timing as well as formulary activities & timing.
The 95-page study, “Increasing Market Access through Innovative Payer Market Research: Assessing New Tools & Technologies to Gain Insight into Payer Decision Making,” includes more than 200 metrics and 20+ narratives from payer research leaders.
Some of the questions addressed in this study include:
• What research techniques work best during different product lifecycle stages to ensure national, regional and government payer access for therapies?
• What drives national, regional and government payer decisions?
• What drives the decision-making of Accountable Care Organizations and Integrated Delivery Networks?
• How are companies communicating and coordinating payer research efforts?
• What are resource and investment levels for payer-focused research?
Thirty-eight payer research leaders participated in this study. More than half of the participants represent pharma or biotech companies, and another quarter come from medical device companies. Five selected participants were interviewed to add qualitative depth to the study.
Among the insights uncovered in the study was that payer landscape research is well used and highly valued:
• Up to 86% use payer landscape research tactics to understand payer decision making
• Value-proposition testing with payers is the most heavily used and most effective tactic
• Mock P&T committees are used to explore parameters that could change payer thinking Reported by PR Newswire.

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