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Pharma is from Mars, payers are from Venus?

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 ( 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.

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Pharma is from Mars, payers are from Venus?

  1. 1. Pharma is from Mars, payers are from Venus? EY Building a better working world Payers matter more than ever, but what matters to payers? Payers want cost but not yet outcomes-based containment models for lowering costs j * 2.62* + 1.27* 1 1|! 3'53 Rising 1'50 Reducing 122* Rising medical Engaging variation New payment drug costs costs patients in care models Payers are most but pharma is somewhat interested in comparative more focused on trial data placebo-controlled trials j O 5.00* 37-32* 4.28* 4.78* Comparative P| aC9b0‘C0n1F0“€d Comparative Placebo-controlled trial data We‘ data trial data trial data Prescription but payers see drugs costs as drugs are only the biggest problem 10% of health 353* Care Costs u '7 Rising drug costs I 2.62‘ Rising medical costs | l I" i, I I. Iliii H. “ I 2.58* Ju_u‘“_u_ Health care reforms Z + 228* 1 Infrastructure/ IT reforms . la”; l~l. | I I 1.50* Engaging patients _ 1.27* I I ‘ ' “ "“ *— Reducing variation in care I w%l I I 1.22‘ New payment models 88% of payers see drug but only 42% of pharma prices as a major driver of respondents agree health care costs 88% 42% * Higher scores indicate higher levels of importance or interest in a particular issue For more on this survey and its implications, download EY's Progressions report at ey. com/ Progressions2014. Find more thought leadership at ey. com/ Iifesciences or join the conversation on our blog (lifesciencesblog. ey. com). Compiled by EY Global Life Sciences Center (®EY_LifeSciences) using survey data from 30 US payers, 30 European payers and 18 pharmaceutical company representatives from functions such as market access and managed markets. © 2014 E‘/ GM Limited. All Rights Reserved. EVG no. FNOI‘/5. ED None