Restoring trust with payers and the public may be the most urgent issue facing the pharmaceutical industry and "lingering mistrust" of the sector will make new forms of engagement highly unlikely without a fundamental change.

That is the key message from Ernst & Young's annual report on the global pharmaceutical industry, entitled Progressions: Navigating the payer landscape. The analysts surveyed 30 US payers and 30 of their counterparts, European payers on their current and future needs and preferences, and 18 global drugmakers on how well they understand the former's needs and attitudes.

Among the findings, EY found that while prescription drugs only account for about 10% of healthcare expenditures, 88% of payers strongly or somewhat agreed that drug prices are a major driver of cost increases, while only 42% of pharma respondents did the same. Furthermore, payers are most interested in comparative clinical trial data, but pharma companies say the data they use most for demonstrating value is from placebo-controlled studies.

The report highlights what it sees as a "trust deficit", with fewer than half of payers (43%) agreeing that pharma’s data is credible for measuring and improving outcomes. Most do not think pharma companies developing 'beyond-the-pill' services can be unbiased between their products and those of competitors, with only 15% of respondents even somewhat agreeing with that statement.

13% say pharma brings affordable drugs to market

Only 20% of payers agreed that pharma products are significantly differentiated from standard-of-care and just 13% said that drugmakers bring affordable products to market. When given a choice of actions that pharma could take to build trust with them, payers ranked “publishing all study findings (positive or negative)” highest, followed by “increasing price transparency” and “participating in real-world evidence/comparative effectiveness research partnerships”.

Among its suggestions to overcome this problem, the report suggests that pharma develops "data-driven insights and interventions" and create customer-centric solutions. Patrick Flochel, EY's global pharmaceutical leader, says payers need help with implementing healthcare reforms, "but while pharma companies have useful data and potential solutions in areas such as drug adherence, they are unlikely to get much traction because payers simply don't trust that they have the impartiality required".

He concluded by saying that "the good news is that payers are open to evolving the types of interactions they have with pharma from simple negotiations around access and price to more strategic, enduring relationships around their biggest challenges". To succeed, "pharma companies will have to approach payers in a fundamentally different way".