Proper acknowledgement of the payer’s perspective is necessary for successful drug development..

The escalating cost of medicines is forcing tough decisions on payers in Europe who are struggling to ensure drug availability while staying within government-dictated healthcare budgets. The resulting austerity measures and related drug price cuts have increased the pressure on pharmaceutical executives to sustain prices and avoid the problems associated with international price differences. However, these events are just the tip of the larger changes happening in healthcare globally…

To improve the financial success of a branded drug, manufacturers must embrace the needs of payers at every stage in a new drug’s development and commercialisation process. Unfortunately, the industry’s longstanding order of developing and launching drugs makes adopting such change an almost Sisyphean task…

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The general analytical process for a typical payer is exemplified by this series of questions:
• Medical need: How strong is the need for a new drug treatment?
• Effectiveness: Does the new treatment address the unmet medical need in a substantial way?
• Evidence: Is the evidence of effectiveness and safety compelling?
• Economic impact: How will the approval impact the budget?
• Ability to control: Can the payer control prescribing volume once pricing and reimbursement is approved?
• Political importance: Would a negative decision have public repercussions?

Considering the payer perspective and evidentiary needs for all payers in countries worldwide would be a complex undertaking. Figure 1 helps make sense of the global patchwork of healthcare systems and their requirements by classifying the world into four key global payer segments that represent different cost management philosophies.

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