The Payer Exchange Podcast Episode 13: USA - Matt Harman On…
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Continuing The Payer Exchange’s US focus, Episode 13 brings an employer-sponsored health plan perspective to the series.
Omar Ali speaks with Matt Harman, VP of Clinical Solutions at Employers Health, whose work supports self-insured employers navigating pharmacy benefits, group purchasing, specialty drug affordability and benefit design.
The conversation examines how US policy changes can flow into commercial healthcare costs, why self-insured employers are stress-testing exposure to high-cost specialty therapies, and how better data is needed to understand medical benefit drug spend.
“I think many employers are now asking an important question; If we cover these today, can we sustain that decision five years from now?”
Matt also explores the affordability challenge created by GLP-1 medicines, opportunities from biosimilars, and how employers are becoming more sophisticated purchasers as Pharmacy Benefit Manager (PBM) models face growing pressure for transparency and accountability.
Key themes:
• GUARD, GLOBE and the potential commercial spillover of Medicare pricing reform
• Specialty pipeline risk, stop-loss exposure and scenario planning
• Visibility and management of Part B / medical benefit drug spend
• Biosimilars as an immediate affordability opportunity
• GLP-1 coverage, utilisation management and long-term sustainability
• PBM transparency, contracting discipline and alternative purchasing models
“I think the real lesson from these global models isn’t necessarily the price benchmark itself, but it’s the idea that individual purchasers often have a little bit more leverage than when they work collectively.”
Share your perspective on The Payer Exchange
We’re always looking to hear from current and former payers, healthcare decision-makers and policy experts from around the world.
If you’d like to take part in a future episode of The Payer Exchange or join Verpora’s global payer network, get in touch with Omar Ali, Verpora’s Head of Payers, by email omar.ali@verpora.com or via DM on LinkedIn.
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About The Payer Exchange
The Payer Exchange is a podcast from Verpora exploring the people, policies and decisions shaping pharmaceutical market access around the world. Hosted by Omar Ali, Verpora’s Head of Payers, each episode features an in-depth one-to-one conversation with payers, policy experts and healthcare leaders, offering direct insight into pricing, reimbursement, access and the practical pressures shaping healthcare systems and pharmaceutical strategy.
At Verpora, we’re all about access strategy, and The Payer Exchange was developed as a way to share discussions we are having every day with payers, policy experts and life science organisations.
Verpora helps pharmaceutical companies bridge the gap between the value of innovation and the realities of healthcare funding. Through our global payer network, evidence, data and strategic market access expertise, we support better decisions, stronger partnerships and, ultimately, better patient access.
If this episode’s conversation has raised questions about your own challenges in market access, pricing, value-based agreements or innovative contracting, or you’d simply like to continue the discussion, we’d be delighted to hear from you - email omar.ali@verpora.com
Disclaimer: This presentation is for educational and informational purposes only, and is not intended as legal or policy advice. This presentation is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else or any organization. No part of this presentation may be reproduced for commercial purposes without the express permission of Verpora.
