Developing evidence that is fit for purpose: a framework for payer and research dialogue

Area of Science:

• Health economics
• Evidence-based medicine
• Health services research

Background:

• Matching evidence supply with demand is crucial for informed healthcare decisions.
• Payers require specific types of evidence to guide their decision-making processes.
• Existing frameworks may not fully capture payers' perspectives on evidence utility.

Purpose of the Study:

• To develop and refine a decision-making framework for evidence generation.
• To incorporate payers' perspectives on the utility of different research methods, including real-world evidence.
• To align the supply and demand of healthcare evidence.

Main Methods:

• Conceptual framework development.
• Literature scan of existing frameworks and payer decision-making literature.
• Refinement through a roundtable dialogue with diverse stakeholders, including payers and researchers.
• Application of the framework to case studies.

Main Results:

• Payers seek evidence on relevant endpoints demonstrating differences between treatment alternatives.
• Evidence needs extend beyond efficacy to include effectiveness, long-term safety, and delivery system impact.
• The framework application provided insights into when and what new evidence is needed for payer decision-making.

Conclusions:

• The developed decision-making framework facilitates communication between evidence generators and payers.
• The framework promotes greater efficiency in the research process by focusing on relevant evidence needs.
• This tool can improve the alignment of research efforts with payer requirements.