March 11, 2022

Assessing Payers’ Preferences for Real-World Evidence in the United States

A research study published in Value in Health (and deemed as one of the Editor’s Choice articles) has determined that US insurance payers have higher preferences for clinical and health-related quality of life outcomes when assessing evidence to inform coverage and reimbursement decisions.

photo of study author Enrique Saldarriaga

Study first-author, Enrique Saldarriaga, 5th year PhD Candidate at The CHOICE Institute

In a discrete choice experiment, 180 employees from payer organizations were tasked to choose between two chronic disease real-world evidence (RWE) studies assuming they were assessing evidence to inform formulary decisions for chronic disease treatment. Each RWE study was characterized by 7 attributes with 3 levels each: very informative, moderately informative, and not measured. The authors used a D-optimal main-effects design. Survey data was fitted to a conditional logit model to obtain a relative measure of the ranking of importance for each attribute. The results of the study found that clinical outcomes were the most preferred attribute. In fact, it was 4.68 times as important as productivity outcomes—the least preferred attribute. It was followed by health-related quality of life (2.78), methodologic rigor (2.09), resource utilization (1.71), and external validity (1.56).

This study provides a quantification of the value payers place on key RWE attributes. The authors found that payers have higher preferences for clinical and health-related quality of life outcomes than the other attributes. Between attributes’ levels, payers prefer high levels of information in clinical outcomes and methodologic rigor but are indifferent in other attributes.
Study first-author, Enrique Saldarriaga, 5th year PhD candidate at the CHOICE Institute says, “The motivation for this study was to bridge the gap between the information that payers seek and the attributes that RWE studies prioritize. We achieved that using a robust methodological framework for the experiment design and analysis. Our findings can effectively guide future research design.” The study was funded by an unrestricted gift from a consortium of biomedical industries to the University of Washington.

Read the full study here.

Saldarriaga EM, Hauber B, Carlson JJ, Barthold D, Veenstra DL, Devine B. Assessing Payers’ Preferences for Real-World Evidence in the United States: A Discrete Choice Experiment. Value Health. 2022 Mar;25(3):443-450. doi: 10.1016/j.jval.2021.09.016. Epub 2021 Oct 30. PMID: 35227457.