LAUSR

Objectives: To explore the impact of Covid-19 on the pricing, market access, and payer evidence requirements in disease areas where new therapies or diagnostics are expected to be “payer disruptive” Methods: A survey-based Covid-19 payer impact tracker covering US and EU (n= 80 EU, 25 US) identified factors that are currently, and likely in the future to be, “payer-disruptive” A targeted literature review (TLR) based on PubMed and Investment Analyst Reports identified likely “payer-disruptive” disease areas 2020-2025 Selection criteria: Low diagnosis rates, significant burden of illness, high unmet need, intensive R&D investment, Investment analyst revenue expectations and major budget impact potential Results: The Covid-19 Payer tracker indicated that: • Economic pressures will increase level of payer intervention/control in disease areas where there are choices/alternatives • Greater focus on level of “medical necessity” and more stringent review of evidence (RCT, RWE, Claims) • Infection control given higher priority with increased willingness to pay Disease modifying therapies being given lower priority;Curative therapies in disease areas of high burden unchanged • Evidence and communication of patient centric outcomes becoming more important as patient affordability and willingness to pay becomes increasingly relevant The TLR identified cell and gene-therapies and personalised (digital and genomic) healthcare as significant future “payer disruptors” NASH was most frequently referenced as a disrupter in the short-term due to high incidence of disease with current low diagnosis / treatment rates that is likely to grow rapidly driven by improved diagnostics and the availability of therapies Conclusions: There is value in tracking the evolution of payer behaviours, evidence requirements, and decision-criteria in disease areas where Covid-19 driven economic turbulence and disruptive innovation is likely to have a significant impact on healthcare systems and budgets This would be useful for informing healthcare policy shaping, advocacy, and clinical / commercial development programmes