Payers Want Real-World Evidence. Why Aren't They Using It?

Only 18% of payers reported regularly using real-world evidence in their decision-making process, even though 80% said they wanted to, according to a survey conducted through AMCP's Research Institute.¹ That gap between interest and actual use sits at the center of a long-running challenge in pharmaceutical market access: manufacturers are generating real-world evidence, but payers often lack the tools and frameworks to act on it. To discuss what's driving that disconnect, Pharmaceutical Commerce spoke with Cate Lockhart, PharmD, PhD, AMCP's chief science officer.

Lockhart leads AMCP's Real-World Evidence Initiative, a multistakeholder effort that convenes pharmaceutical manufacturers and payers to bridge a persistent communication gap between the two groups.² Among the earliest barriers the initiative surfaced was that payers often didn't know what real-world evidence was available to them, had to request it directly from manufacturers, and had significantly less experience evaluating observational research than clinical trial data. A lingering mistrust of manufacturer-sponsored studies compounded the problem, as did recurring questions about whether a given study's patient population was actually representative of a payer's own membership.¹

AMCP has since published its Real-World Evidence Standards in the Journal of Managed Care & Specialty Pharmacy, addressing that gap directly. The standards establish a framework for which study types and endpoints matter to payers at each stage of a product's life cycle, and include a 29-criteria checklist across six categories that manufacturers can use as a common template when presenting real-world evidence to payer decision-makers.¹

In this first installment of her conversation with Pharmaceutical Commerce, Lockhart discusses the most common challenges payers face when evaluating real-world evidence, including difficulty locating relevant studies, limited experience with observational research, and lingering skepticism toward evidence produced by pharmaceutical manufacturers.

References

1. Lockhart CM, et al. AMCP real-world evidence standards: Overcoming barriers to using real-world evidence in US payer decision-making. J Manag Care Spec Pharm. 2025;31(12):1230-1236. Published online June 27, 2025. Accessed June 22, 2026. https://www.jmcp.org/doi/10.18553/jmcp.2025.25108
2. Academy of Managed Care Pharmacy. Real-World Evidence (RWE) Initiative. AMCP.org. Accessed June 22, 2026. https://www.amcp.org/real-world-evidence-rwe-initiative