Choosing payer pricing research? Start with the question, not the methodology

Different budget pressures create different payer pricing challenges 

Healthcare budget pressure is taking different forms across therapeutic areas and countries. High-volume medicines, including glucagon-like peptide-1 (GLP-1) receptor agonists, can create immediate population-level affordability concerns as costs accumulate across large eligible populations. Oncology launches add sustained expenditure as multiple new medicines enter increasingly complex treatment pathways. Rare disease medicines create a different pressure: although patient populations are small, orphan medicines often carry high per-patient treatment costs. The number of orphan medicinal products approved in the EU rose from 19 in 2010–2012 to 68 in 2020–2022¹, increasing the number of potentially high-cost therapies that healthcare systems may need to fund. These different budgetary pressures can increase payer focus on affordability, budget impact and evidence of incremental value. 

Early payer research protects strategic flexibility on price  

For manufacturers, this challenging payer environment, characterised by stringent evidence thresholds, affects both achievable net price and access, through discounts, narrower eligibility criteria, or the need for managed access arrangements. If risks emerge only during formal reimbursement discussions, manufacturers may have limited ability to address payer concerns, face reduced negotiating flexibility and rely more heavily on discounts alone to secure access.  

Targeted payer research can help identify and manage pricing and evidence trade-offs, while there is still scope to adapt the evidence plan. Additionally, it can reduce downstream payer-negotiation risks by providing insight into the relationships among product attributes, decision drivers, net price and access conditions, including the eligible population and contractual arrangements.  

This article focuses on the importance of defining the pricing decision and the uncertainty that the research must resolve. The accompanying Payer pricing methodology selector then helps map that question to the most appropriate research approach, what it can reveal and when it may be useful.

Start with the strategic question 

Research design should start with the decision the business needs to make to avoid pricing corridors and underlying decision-making becoming too broad. Indeed, a broad price corridor may be appropriate during early pricing research, but as time progresses, it can provide limited direction on what should change in the pricing, evidence or access strategy. 

Research design should therefore begin with the product-specific pricing decision that the manufacturer needs to inform. The most appropriate approach will depend on the maturity of the product profile, the uncertainty creating the greatest strategic risk and the aspects of the evidence, pricing, access or negotiation strategy that can still be changed.  

Five questions to define your payer pricing research objective: 

• Decision and action: What strategic decision must the research inform, and which aspects of the strategy can still be changed? 

• Core uncertainty: Which untested assumption or evidence gap creates the greatest risk to the proposed price or access strategy, and does it concern price acceptance, evidence trade-offs, payer objections, access conditions or negotiation dynamics? 

• Decision boundary: Which payer outcome needs to be understood and what change in price, evidence, eligible population or contracting terms could alter it? 

• Product maturity: Is the aim to explore an uncertain price corridor, stress-test a defined positioning or rehearse a negotiation strategy? 

• Context: In which markets or payer groups must the question be answered, and could their responses differ materially? 

Together, these questions turn a broad concern about price into a focused, actionable research objective. They also establish what the research needs to reveal, whether that is a change in payer acceptance, a trade-off between evidence and access, a priority objection, a reimbursement boundary or a negotiation risk. 

Importantly, the method should follow the question. Two assets with similar target prices may require very different research if one is still shaping its evidence plan and the other is preparing for negotiation. 

Already clear on your strategic question? Download our Payer pricing methodology selector to see which approaches can address it, what each can reveal and when each may be most relevant. 

Using payer insight to strengthen pricing decisions 

It is important to consider that no single approach can determine a definitive launch price. The value of this research lies in understanding the conditions under which payer responses may change and using those insights to refine pricing assumptions, evidence plans, access options and negotiation preparation whilst there is still scope to act. 

Therefore, selecting and, where appropriate, combining approaches against a clearly defined strategic question can support a more resilient, market-specific pricing strategy as payer expectations continue to evolve. 

What robust payer pricing research enables 

When applied appropriately, these approaches can provide manufacturers with:  

• A better understanding of where pricing assumptions may be most exposed to payer pressure early on 

• Greater insight into the trade-offs between price, clinical evidence, budget impact and access conditions to reduce commercial risk 

• Identify early risks to pricing assumptions and mitigating opportunities, including payer objections and evidence uncertainties  

• Stronger internal alignment and negotiation readiness to support a realist commercial ambition 

Resources

1. Bouwman L, Sepodes B, Leufkens H, Torre C. Trends in orphan medicinal products approvals in the European Union between 2010–2022. Orphanet J Rare Dis. 2024;19:91. doi:10.1186/s13023-024-03095-z. 
2. Lipovetsky S, Magnan S, Zanetti Polzi A. Pricing models in marketing research. Intell Inf Manag. 2011;3(5):167–174. doi:10.4236/iim.2011.35020. 
3. Dhanda DS, Veenstra DL, Regier DA, Basu A, Carlson JJ. Payer preferences and willingness to pay for genomic precision medicine: a discrete choice experiment. J Manag Care Spec Pharm. 2020;26(4):529–537. doi:10.18553/jmcp.2020.26.4.529. 
4. IntuitionLabs. Payer objection handling: best practices in pharmaceutical industry. IntuitionLabs website. Published 18 April 2025. Accessed 27 July 2026. https://intuitionlabs.ai/infographics/educational-posters/payer-objection-handling-best-practices-pharma 
5. Chalmers K, Armand J, Rinciog C. EE716 Unlocking pricing power with threshold analysis: conclusions from a hypothetical Markov model. Value Health. 2024;27(12 Suppl). doi:10.1016/j.jval.2024.10.996. 
6. Wettstein DJ, Boes S. The impact of reimbursement negotiations on cost and availability of new pharmaceuticals: evidence from an online experiment. Health Econ Rev. 2020;10:13. doi:10.1186/s13561-020-00267-y. 

Frequently Asked Questions

When should payer pricing research be conducted? 

Payer pricing research should begin while there is still scope to change the product profile, evidence plan, value proposition or pricing and access strategy. It should then be repeated as evidence and launch assumptions mature. Early research can identify vulnerable assumptions and evidence gaps, while later research can stress-test price scenarios, access conditions, payer objections and negotiation strategies. 

What makes payer pricing research robust? 

Robust payer research starts with a clearly defined strategic decision rather than a preferred price to validate. It requires realistic product and evidence scenarios, the right payer stakeholders and a methodology matched to the uncertainty being explored. Findings should also be interpreted in context and triangulated with other evidence, rather than treating individual payer responses as precise predictions of future reimbursement decisions. 

How should manufacturers choose the right payer pricing research methodology? 

The methodology should be selected according to the decision the research needs to inform, the main uncertainty and the maturity of the pricing strategy. Early research may explore potential price ranges or evidence trade-offs, whereas more mature strategies may require threshold testing, objection testing or negotiation simulation. The key is to choose the approach that best reveals the payer decision boundary relevant to the business question. 

Can payer pricing research determine the right launch price? 

No payer research methodology can determine a definitive launch price. Its value lies in identifying credible price ranges and understanding the conditions under which payer responses may change. For example, research can explore how changes in price, evidence maturity, eligible population, budget impact or contracting terms could shift a payer from broader reimbursement towards restricted access, further negotiation or non-reimbursement. 

What are the most common pitfalls in payer pricing research? 

Common pitfalls include starting without a clear decision question, selecting a methodology that does not align with the research objective, recruiting payers without the relevant decision-making perspective, and testing unrealistic evidence or price scenarios. Manufacturers should also avoid over-interpreting small samples or stated willingness to pay. The objective is to understand decision drivers and boundaries, not to create false precision around future payer behaviour.