OBJECTIVES Assess the role of industry, policy makers and assessors in the current short-termism in the evaluation of new pharmaceutical interventions and identify options for change to greater recognize the value brought by breakthrough changes

METHODS Structured, qualitative discussions were held with a range of pharmaceutical industry executives (n=15). Key topics included the perception of the market preparation process, examples of successful and unsuccessful pre-launch market preparation, and the role of different actors and alliances in delivering change

RESULTS The study identified ten common issues which contribute to the current cycle of short term industry investment, short term horizons of payer planning, and short-term focused healthcare policy that values the marginal but well characterized over larger more nebulous gains. Examples are used to show how different elements of the healthcare ecosystem (different industry functions, HTA bodies, academics, policy makers and patient bodies) react to breakthrough innovation

CONCLUSIONS This study provides an informed vision of how a more holistic perception of value is needed to capture the societal gains of truly innovative, breakthrough therapies, and this will require tailored approaches from each actor and each situation. The current vicious cycle of short-termism is not optimal for all actors in healthcare, or society at large