OBJECTIVES: Identify the current and future relevance of Patient Reported Outcomes (PROs) among U.S. payers making patient access decisions for pharmaceuticals METHODS: Double blind, semi-structured telephone interviews with 12 U.S. payers, including: National and regional commercial payers; Accountable Care Organizations; Pharmacy Benefit Managers; Self-insured employers; Actuaries; Veterans Affairs; and Department of Defense. Interviews included open-ended questioning and structured rating scales where 10=highest and 1=lowest possible score per concept. RESULTS: Payers perceive PROs as the, “Consequences of the disease and drug as assessed by the patient...” Average rating scale responses were:

1. How relevant are PROs?
• today? = 3.7
• in 5 years? = 6.4
2. Would you like to see more PRO evidence?
• today? = 6.1
• in 5 years? = 6.6
3. Should pharmaceutical companies invest more in PROs?
• today? = 5.6
• in 5 years? = 6.3

The sum of the 6 scales (min= 6, max = 60) ranged from 12 to 58, highlighting diversity across payers.  PRO relevance was associated with the duration of enrollment and thus total amount of risk. DoD and ACOs reported the highest relevance, National Commercial Health plans the lowest. Education was consistently identified as a need to aid interpretation of PRO data to support patient access decisions. CONCLUSIONS: Payers' reliance on PRO data will increase in the next five years, especially in symptomatic conditions without objective measures of success. PRO evidence is valued as a unique predictor of clinical and economic outcomes and as a key element of performance and quality ratings. Respondents showed interest in pharmaceutical companies’ increasing use of PROs in clinical trials, creation of real world evidence and supporting PRO education.