Background
Medical affairs organizations have historically relied on various methods to assess payer sentiment toward clinical evidence and health economic value. These methods include advisory boards, surveys, and market research, each of which has inherent limitations. While they provide valuable insights, these approaches are often time-consuming and resource-intensive and lack the agility needed for real-time decision-making. Given the rapidly evolving nature of medical evidence and payer landscapes, there is a critical need for a more dynamic and responsive tool for medical payer teams to assess payer organizations’ knowledge, attitudes, and behaviors regarding clinical evidence and health economic value.
Objective
The primary objective of this project was to develop an agile assessment tool that medical affairs professionals could use to systematically evaluate payer organizations’ knowledge, attitude, and behavior toward clinical evidence and health economic value. This tool would allow for continuous and iterative assessments, ultimately enhancing scientific engagement efforts, including understanding of perceived evidence gaps and strategic decision-making.
Methods
To create the assessment tool, the authors conducted a non-exclusive PubMed literature search using key terms such as “behavioral mindset,” “mindset continuum,” “knowledge assessment,” “attitude assessment,” and “behavior assessment.” The search yielded over 200 responses, which were then systematically narrowed down to five validated models. After careful evaluation, the authors selected the Intercultural Development Continuum™ as the foundation for the tool, due to its inherent flexibility in adapting to changes in medical evidence and payer perspectives over time.
A working group comprising field medical outcomes liaisons—who regularly interact with regional and national payer organizations—collaborated with medical strategy leadership to define and categorize different levels of knowledge, attitude, and behavior. This collaboration ensured that the tool was both practical and reflective of real-world payer engagement dynamics. Definition criteria were developed for each category, facilitating standardized implementation and interpretation across teams.
Results
The resulting assessment tool structures payer organizations’ knowledge and attitude into five distinct categories:
- Skepticism – Payers express doubt or require additional evidence to consider clinical value.
- Awareness – Payers acknowledge the existence of the message but may not yet be engaged.
- Consideration – Payers actively evaluate the clinical message and its implications.
- Engagement – Payers are involved in discussions and demonstrate a willingness to act on the clinical value.
- Advocacy – Payers proactively support and champion the clinical value.
Payer behavior is categorized based on formulary status, with three levels:
- Non-formulary – The asset is not covered within the payer’s formulary.
- Non-preferred – The asset is covered but not as a preferred option.
- Preferred – The asset holds a favorable formulary position.
Field medical affairs professionals complete these assessments quarterly for individual priority assets, with emphasis on new products and indications or changes in the competitive landscape. This allows for longitudinal tracking of payer sentiment, enabling organizations to identify trends, refine engagement strategies, and adjust medical evidence generation efforts accordingly.
Conclusion
The development of this assessment tool provides a quick yet structured method for field medical professionals to gauge payer organizations’ sentiment toward clinical evidence and health economic value. By offering a standardized framework, the tool enables more informed account planning and supports strategic medical engagement. Over time, this approach has the potential to improve understanding of clinical value perceptions and evidence gaps that ultimately inform medical strategies to address payer-decision maker evidence needs.
Sponsorship
This project was conducted by Sanofi employees.
About the authors:
Casey Reed, PharmD, MBA, MS, MSc, CS
Casey is the Population Health Lead within the NA Medical organization at Sanofi. In this role, Casey leads strategic medical engagement efforts across multiple therapeutic areas, focusing on organized customers (payers, IDNs, specialty pharmacies, etc.). Casey has held multiple leadership roles across both pharma and managed care organizations, with a focus on population health, quality improvement & implementation science, real-world evidence generation, and data storytelling.
Darren Stam, PharmD, MBA
Darren is currently the Head of Medical Outcomes and Portfolio Strategy within the NA Medical organization at Sanofi. Darren’s career in the pharmaceutical industry has spanned 26 years where he has had the opportunity to build and lead field medical teams, including traditional MSL and Medical Outcomes roles that span the spectrum of stakeholder engagement within the US healthcare ecosystem. During his time at Sanofi, he has accumulated significant experience aligning field medical as a key contributor to launch readiness and engagement and has led initiatives to expand opportunities for proactive scientific exchange, elevating medical’s contribution the external scientific engagement.
Have an opinion on this article? Send a message to the editor.