Medical Affairs organizations often face challenges in the planning and management of payer engagement and market access activities. This Research Report from Best Practices, LLC Illustrates how leading Pharma and Biotech companies structure and organize their payer groups and Medical Affairs’ involvement with it. It highlights strategies for building and maintaining effective relationships with payers and seeks to understand resource levels for Medical Affairs to create effective payer relationships. This report can be used by Medical Affairs leaders for talent acquisition and training for their payer groups. It can be used to explore strategies for identifying, segmenting and prioritizing payers. Download Full Report: http://bit.ly/2b0BJq0

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Medical Affairs’ Critical Role in
Payer Interactions
Best Practices, LLC Strategic Benchmarking Research & Analysis

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Table of Contents
 Executive Summary pgs. 3-10
 Research Overview pg. 4
 Participating Companies & Segmentation pg. 5-6
 Key Recommendations pg. 7
 Key Findings & Insights pgs. 8-12
 I. Capturing Payer Insights and Partnerships with Payers pgs. 13-23
 II. Field Resources for Payers pgs. 24-30
 III. Talent Background and Training pgs. 31-39
 IV. Knowledge Sharing pgs. 40-48
 V. Payer Segmentation and Prioritization pgs. 49-54
 VI. Medical Affairs and Payer Resource Ratios pgs. 55-58
 VII. Medical Affairs Leadership and Structure pgs. 59-62
 VIII. Demographics pgs. 63-65
 XI. About Best Practices, LLC pg. 66-67

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Field Research & Insight Development
Twenty nine survey responses from Medical Affairs
leaders at 27 biopharmaceutical companies. This
report captures insights on two segments:
Company Size Segments: Large (> $10B in
revenue), Mid-Size ($1B-$10B in revenue) and
Small (< $1B in revenue)
Regional Segments: Global (Respondent works
under the global Medical Affairs group) and US-only
(Respondents focus is only US) regions
Provide Leading Insights on:
• Identifying critical requirements
for Medical Affairs to be
successful in payer activities
• Create strategies to build and
maintain strong partnerships and
relationships with payers
Research Objectives & Methodology
Research Objectives:
 Illustrate how leading Pharma and Biotech companies structure and organize their payer groups and
Medical Affairs’ involvement with it
 Highlight strategies for building and maintaining effective relationships with payers
 Understand resource levels for Medical Affairs to create effective payer relationships
 Guide Medical Affairs for talent acquisition and training for their payer groups
 Explore strategies for identifying, segmenting and prioritizing payers
Business Objective
This research delivers current data, insights and best practices from Medical Affairs leaders at top biopharmaceutical
companies. The benchmark data in this study will help companies find better ways to create strong Payer Relationships

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Universe of Learning: 27 Top Companies Contributed to This Research
This study engaged with 29 executives from 27 leading biopharmaceutical companies. Eleven research participants
represented large biopharmaceutical organizations, while 9 participants represented medium companies and the remaining
benchmark class emerged from small companies. Also 17 companies form a US-only segment, while 12 companies form a
Global segment.
Benchmark Class

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Study Analyzes Two Main Segments
% Respondents
Benchmark Class
Regional
Segments
Company Size Segments
US-only Global Large
Companies:
Revenue > $10B
Medium Size
Companies:
Revenue $1B –
< $10B
Small
Companies:
Revenue < $1B
N=17
N=11
N=29
N=12
N=9 N=9

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Key Findings for Medical Affairs’ Role in Payer Interactions
 Capturing Payer Insights: Medical Affairs plays a critical role in probing payer needs and perspectives.
The top three activities that Medical Affairs groups design and manage are:
 Clinical presentations and discussions with payers (used by 100% of the benchmark class)
 Advisory boards / forums for payers (used by 93% of the benchmark class)
 Outcomes research presentations (used by 90% of the benchmark class)
 Payer Field Resources and Trends: Seventy-six percent of the participants don’t’ have specialized
health outcomes liaisons to interact with payers. A majority deploys medical science liaisons to the field in
order to build and maintain relationships with payers.
 Regardless of company size, all companies utilize part of their MSL teams to communicate with payers.
 While larger companies have more focus on specialized resources for payers, smaller companies rely
more on managed care liaisons.
 About one fourth of the participants expect more than 30% growth in the staff that works in the area of
payer relationships.
Few of the key findings and insights from this study:

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Critical Elements: Payer Needs, HEOR, Internal & External Communication
Critical Elements of Strong Payer Communications
Building and
Maintaining
Strong
Relationships
with Payers
Understanding
Payers’ Needs
Health
Economics &
Outcomes
Research
Internal
Knowledge
Sharing
Conveying the
Value
Understand the current trends in
the market as they pertain to
payers
Communicate with payers at the
product development process to
address their needs better
Translate clinical benefits to
payers’ value discussions
Communicate real world
evidence showing a positive
health impact
Create a Dedicated HEOR team
for key customer accounts
Acquire experienced talent:
Seek employees from
competitors and payers
Plan face-to-face meetings
between payer groups and
Medical Affairs
Create cross-functional training
programs to help employees
understand each others strengths
and weaknesses

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N=29
Medical Affairs Leads Activities that Require Scientific Communication
Q4. Capturing Payer Insights: What roles do your Medical Affairs professionals play in carrying out
activities designed to probe payer needs and perspectives?
Ninety percent or more of the Medical Affairs groups lead: Clinical Research, Advisory Boards and Outcomes Research
communication. It’s critical for Medical Affairs to manage activities that require scientific interactions.
BenchmarkClass
100%
93%
90%
82%
79%
72%
69%
61%
57%
55%
52%
52%
Clinical presentations & discussions
Advisory boards/ forums for payers
Outcomes research presentations
Executive exchanges
Competitor analysis
Focus groups targeting payers
Virtual advisory boards
Acquisition of input from payers
Segmentation stratification of payers
Discrete-choice modeling of payer decision-making
Behavioral economics research
Conjoint studies probing payer decisions
Capturing Payer Insights
% Respondents Leading
and/or Supporting

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N=29
Medical Science Liaisons Lead Payer Relationships
Other: Not part of the medical function
% Respondents
More than half of the respondents deploy MSLs without any specialization to manage payer relationships. Health
outcomes liaisons and specialized MSLs are favored only by one-fifth to one-fourth of the participants.
BenchmarkClass
Q6. Payer Field Resources: What type of field-based resources have your
Medical Affairs organization deployed to support payers?
3%
7%
10%
10%
10%
21%
21%
24%
52%
Other
Part of HOL team without specialization
Nurse educators
Specialized managed care liaison groups
We don’t provide any field-based resources for payers
Managed care liaisons (MCLs) without any specialization
Specialized medical science liaisons (MSLs) for payers
Specialized health outcomes liaisons (HOLs) for payers
Part of MSL team without specialization
Payer Field Resources

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N=29
Scientific Background is Critical for Payer Interactions
Other: PhDs in HEOR, MPH
% Respondents
More than 90% of the companies find two educational backgrounds highly effective or effective for staffing payer-oriented
activities: Pharmacy or Medical (MD).
BenchmarkClass
25%
4%
4%
20%
50%
70%
13%
24%
29%
36%
42%
22%
12%
13%
12%
4%
4%
63%
60%
54%
32%
4%
4%
Other
Chemistry
Biology
Nursing
Medical (MD)
Pharmacy
Talent Background
Highly Effective Effective Ineffective Don't Employ
Q15a. Effectiveness of Educational Background: Rate the effectiveness of staff with
the following educational backgrounds for your payer services.

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Best Practices®, LLC is an internationally recognized thought leader in the field of best practice
benchmarking®. We are a research, consulting, benchmark database, publishing and advisory firm that
conducts work based on the simple yet profound principle that organizations can chart a course to superior
economic performance by leveraging the best business practices, operating tactics and winning strategies of
world-class companies.
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