Addressing the challenges of collaborating with the US healthcare system's immensely fragmented web of private payers remains a work in progress for the pharma industry. Pharm Exec asked two experts on the payer/pharma interface, the Arcas Group's Jan Heybroek and PriceSpective's Ted Sweeney, to have a wide-ranging (albeit oncology-focused) conversation about where these two stakeholders stand at the current moment of great uncertainty in the healthcare industry and what new trends and strategies are in the offing. — Walter Armstrong, Senior EditorPharm Exec: To start off with broad strokes, what's the big story about pharma's hopes and fears regarding the growing power of payers?
Jan Heybroek: There has been a significant increase in efforts by US commercial teams in pharma and biotech to understand the interaction between physicians and payers, especially in the oncology space, which is not surprising given the high value or high cost of these drugs. We see a similar trend toward a deeper understanding of the whole payer side of the business—and not just to understand but to impact it.
Ted Sweeney: Absolutely. Over the past five years, the recognition that payers are one of the ultimate market stakeholders has gained traction, and you see that reflected even in the organizational structure of pharma companies: the focus on market access and payer landscapes. Its reach is really quite remarkable—that information is used as input even into decision making about drug development and clinical trial structure. But there's also the recognition that the payer isn't necessarily the clinical expert. Payers rely on the physician community and other external expertise, especially in rapidly evolving, specialty disease states, like oncology.