Payers don't trust pharma. The fix? Risky trials and transparency

New survey research finds that the majority payers in the US and Europe believe that drug adherence solutions and data that pharma companies possess are vital to lowering health care costs and improving outcomes. However, lingering mistrust of the pharma industry is likely to stymie efforts by pharma companies to engage with payers in these areas without a fundamental change from current approaches. These and other findings were released today in Progressions: Navigating the payer landscape, Ernst & Young 's annual report on the global pharmaceutical industry.

As part of this year's Progressions report, Ernst & Young surveyed 30 US payers and 30 European payers on their current and future needs and preferences, and 18 global pharmaceutical companies on how well they understand payers' needs and attitudes. This survey was supplemented by in-depth interviews with industry executives in the US and Europe. Key findings include:

Costs above all else: Payers are focused on cost containment and budgetary predictability over outcomes-based approaches. While prescription drugs only account for about 10% of health care expenditures, payers see curbing rising drug costs as a more important business challenge than non-drug costs. Eighty-eight percent of payers strongly or somewhat agreed that "drug prices are a major driver of health care cost increases", while only 42% of pharma respondents did the same.

There's a disconnect on data: While payers are most interested in comparative clinical trial data, pharma companies say that the data they use most for demonstrating value is from placebo-controlled trials.

Pharma has a trust deficit: Seventy-eight percent of payers agree that "boosting drug adherence is a critical component of lowering health care costs" and 57% agree that "pharmaceutical companies have data that is vital for measuring and improving outcomes". However, fewer than half of payers (43%) agree that pharma's data is credible for measuring and improving outcomes.
Most payers do not think that pharma companies developing "beyond-the-pill" services can be unbiased between their products and those of competitors, with only 15% of respondents even somewhat agreeing with that statement.

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"More than ever, payers today need help with implementing health care reforms. But while pharma companies have useful data and potential solutions in areas such as drug adherence, they are unlikely to get much traction because payers simply don't trust that they have the impartiality required," said Patrick Flochel, EY's Global Pharmaceutical Leader. "The good news is that payers are open to evolving the types of interactions they have with pharma from simple negotiations around access and price to more strategic, enduring relationships around their biggest challenges. To succeed, pharma companies will have to approach payers in a fundamentally different way."

Building blocks for strategic payer engagement

In response to health reforms focusing on outcomes, many pharma companies have been experimenting with services and solutions that expand beyond the pill. In considering the adoption or expansion of such approaches, companies should abide by some guiding principles to engage with payers:

Making the right comparison. At a time of rapid change, pharma companies should make decisions about moving beyond the pill based on comparisons to the drug business of tomorrow, not the drug business of yesteryear.
Approaching payers strategically and comprehensively. To move beyond pilots, Progressions suggests four key components: screening payers to identify the best targets; segmenting to customize offers to different payers; sequencing to expand solutions more broadly over time; and building sustained, enduring relationships.
Developing data-driven insights and interventions. The big opportunity in engaging payers with big data is in building the complete picture and targeting the small percentage of patients who will drive the biggest percentage of costs.
Creating customer-centric solutions. Payers are interested in solutions that look across disease franchises, span the cycle of care and are unbiased between the products of different manufacturers. Pharma companies need to ensure they are creating solutions that help payers address their challenges — rather than merely to sell more product.
Being transparent to rebuild trust. Without trust, pharma's data and solutions will get little traction with payers.

"Solving complex health challenges will require collaborations among many participants in the health ecosystem – including pharma companies and payers. Thus restoring trust with payers and the public is perhaps the most urgent and important issue facing the pharmaceutical industry today," says Glen Giovannetti, EY's Global Life Sciences Leader. "This is no longer just about doing the right thing — it's about doing the right thing for business. Companies urgently need to become more consistent, proactive and transparent in trust-building initiatives."