Strengthening Patient Experience Data Reliability in Payer Decisions

Advances in the collection and standardization of patient experience data (PED) may boost their role in payer decision-making, but evaluators still need a simpler way to assess their credibility, Jennifer S. Graff, PharmD, of Innov8 Health Policy, said in the second part of her interview at the Academy of Managed Care Pharmacy (AMCP) Nexus 2026 meeting.

Graff noted that PED have been collected for more than 20 years, but digital technologies have made the process far easier. For example, patients can now log information in real time, such as rating their sleep quality through a wearable device.

However, Graff emphasized that 2 needs remain. First, outcomes must be standardized across a disease so that a condition such as multiple sclerosis is not assessed using 11 or 12 different measures. Second, managed care decision-makers need a simpler way to evaluate studies for credibility and reliability, using a brief set of questions rather than the 189 pages of existing FDA guidance.

Graff also outlined key insights from AMCP's Partnership Forum on PED and payer decision-making. These include building awareness of what PED are, ensuring the data are usable and credible, and connecting them to relevant outcomes, including adherence and financial outcomes.

Equally important, she said, is communicating PED at or before the time payers make decisions. This means incorporating the data into the resources payers use to understand how a drug improves clinical, humanistic, and economic outcomes, including pre-approval information exchange decks, dossiers, and publications.

Lastly, Graff highlighted that PED are more common than many realize, as they are included in about 80% of new drug approvals and about 40% of corresponding product labels. However, many may not recognize that these data are considered PED.

“There’s a key opportunity to help managed care decision-makers understand what it is that they’re looking at, be aware of it, and then look and ask for those…questions that help them trust in the data,” Graff concluded.