Health care is being reshaped by a move to outcomes and value and payers are leading the way. For pharma companies, navigating the payer landscape at a time of tremendous change poses challenges and raises many questions. To better understand the complex and changing payer landscape, EY conducted a survey of US and European payer organizations and pharmaceutical companies (http://www.ey.com/GL/en/Industries/Life-Sciences/EY-progression-2014) and found there were some common themes. 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.