Using Real World Evidence to Drive Affordability of Specialty Drugs

Real World Evidence (RWE) is fast becoming a key differentiator in the crowded and competitive pharmaceutical landscape, and more so in the specialty drug segment. RWE refers to the evidence and insights gained from the observation of clinical outcomes in “real world” practice settings. The ability of pharma companies to capture this evidence and extract meaningful insight from it could deeply impact every aspect of the pharmaceutical value chain.

One RWE use case in particular which is gaining traction is in enabling pharmaceutical manufacturers to showcase value to payers in the specialty drug segment. Specialty drugs are the fastest growing driver of the pharmaceutical industry and represent one of the highest innovation areas in Life Sciences. Though specialty drugs constitute only a small fraction of all prescriptions, they are projected to constitute 50% of all pharmaceutical expenditure by 2018 (Source: “Drug Trend Report.” Express Scripts. 2015).

Most experts have opined that this trend is not sustainable. In light of this, the U.S. Federal government has implemented a broad range of structural reform as part of the Affordable Care Act, which introduced the concept of measuring and paying for quality (i.e., improved outcomes, rather than fee-for-service). This single change marks a watershed moment in U.S. health-care and promises to completely change the dynamic between payers and pharmaceutical manufacturers moving forward.

In today’s environment, health plans are increasingly looking to control expenditures on specialty pharmaceuticals by focusing on therapies that demonstrate best real-world outcomes. Real-world data and insights generated from these therapies, such as treatment pathways, are critical weapons in the hands of payers in demanding better economic value for drugs.

Specialty drug manufacturers have long relied on results from randomized clinical trials to showcase the value of drugs and protect their margins. With the huge impact of real-world data (claims, electronic health records) now influencing efficacy and effectiveness conclusions and driving health plan reimbursement decisions, the consumer stands to benefit through improved clinical outcomes as well as lower healthcare costs.

Learn how Saama, through our expertise in real world life sciences datasets and our powerful RWE Analytics solution suite, is partnering with pharmaceutical clients to help them derive actionable insights from Real World Evidence and drive up their level of agility to compete in an increasingly fast paced drug delivery life cycle.

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