In this final episode of our first series, I speak with Jaime Espín—health economist, former adviser to the Spanish Ministry of Health, and one of the country’s most recognised payer voices.We explore the latest regulatory reforms reshaping access in Spain, a move toward greater transparency in payer decision-making, and the country’s experimentation with outcomes-based and staged payment models for innovative medicines.It’s a compelling look at a system in transition—and a fitting close to a series that’s revealed how differently payers around the world are grappling with shared challenges.About The Payer ExchangeThe Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets. The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.DisclaimerThis podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.
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E4: Netherlands - Hans Serverens
In this episode, I speak with Professor Hans Severens, former Vice Chair of the Dutch Health Council and a key figure in health technology assessment at ZIN in the Netherlands.We dig into how the Netherlands is advancing value-based pricing frameworks, why severity of disease may outweigh rarity in reimbursement discussions, and the pressures of sustaining a publicly funded system in the face of high-cost therapies.Hans brings a considered and critical lens to how access decisions are made, and offers a Dutch perspective on balancing economic realism with equity and innovation.About The Payer ExchangeThe Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets. The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.DisclaimerThis podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.
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E3: Italy - Fabrizio Gianfrate
In this episode, I’m joined by Professor Fabrizio Gianfrate, a voting member of AIFA—the Italian Medicines Agency—and a long-time figure in European health economics.We explore why Italy is viewed as a strong market for rare disease access, the growing friction between good patient access and lower pricing, and how delayed payment and instalment models are creating challenges for innovative contracting in Italy’s system.It’s a fascinating look at a market that often flies under the radar, with real-world insights from someone deeply embedded in both policy and practice.About The Payer ExchangeThe Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets. The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.DisclaimerThis podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.
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20:17
E2: Germany - Detlev Parow
In this episode, I speak with Detlev Parow, a former payer from one of Germany’s largest statutory health insurance funds. We unpack how German systems are managing access and affordability—sometimes in surprising ways.Detlev shares why, in Germany, obesity drugs might not be the budgetary problem everyone assumes, why multiple indications don’t always mean lower prices, and how gene therapies are being handled through outcomes-based guarantees.Along the way, we hear what it’s like to negotiate from “the dark side” and get a glimpse into a payer mindset shaped by pragmatism, experience, and a few unexpected views.About The Payer ExchangeThe Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets. The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.DisclaimerThis podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.
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32:49
E1: France - Jean-Claude Castanier
In our first episode, I’m joined by Jean Claude Castanier, a former CEPS member and leading voice in France’s pricing and reimbursement landscape. We talk about the ongoing challenge of preserving net price across multiple indications, the payer’s role as a public communicator, and what long-term sustainability really means for healthcare systems under pressure.From confidential discounts to transparency, and the tension between innovation and affordability—this is a grounded look at one of Europe’s most closely watched pricing systems.About The Payer ExchangeThe Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets. The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.DisclaimerThis podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.
Unscripted conversations with the people shaping drug pricing, access, and reimbursement around the world.Hosted by Omar Ali, Head of Payers at Verpora, The Payer Exchange brings you honest, off-the-record discussions with payers working at the frontline of healthcare funding. Each episode features a one-to-one conversation with a payer from a different country—exploring local challenges, emerging trends, and contrasting approaches to some of the biggest questions in market access.From horizon scanning to contracting, rare disease to real-world evidence, we ask the same core questions—but get different answers every time.This isn’t a panel. It’s not a pitch. It’s a rare chance to hear what really drives decision-making—direct from those making the decisions.
Netherlands