OBJECTIVES: Customer segmentation is a strategic tool employed by the pharmaceutical and life sciences industries traditionally focusing on understanding physicians and patients. With resources and budget cuts, pharmaceutical companies have increasingly identified the need to successfully and cost-effectively prioritise and target payers by understanding their drivers, motivations, barriers and limitations when assessing, endorsing or restricting new products. Our study aimed to develop an attitudinal based, scalable payer segmentation model to investigate payers’ attitudes and behaviours towards the managed entry of novel agents in the cardiology area in the health care systems of countries within the EU. METHODS: A quantitative data collection and advanced statistical analysis methodology was employed with regional and local payers in eight markets to define the segmentation according to attitudes and beliefs relevant to the therapy area. Subsequently, in-depth semi-structured telephone interviews were conducted to explore the rationale behind payers’ views, along with perceived challenges relating to the entry of novel class of cardiovascular agents. RESULTS: Quantitative segmentation identified four key distinct segments of payers displaying unique attitudes and beliefs towards entry of the novel class of cardiovascular agents. The segmentation approach identified key differentiating factors between segments, allowing full profiling of each group. Payers’ underlying values were identified and expanded upon resulting in insight to what is important to them as individuals as well as decision-makers, what motivates them and what restricts them. CONCLUSIONS: This method of segmentation proved valuable in gaining payer insights which were utilized to prioritise targeting of payer segments. In addition, communication and messaging strategies were optimised for these payer groups. The findings helped inform service redesign strategies within health care systems to include the novel agents in the treatment guidelines and to reduce human and financial resources when treating the specific condition.