Evidence map›Paper›PMID 40936210›Full record

ArticleInternational journal of technology assessment in health care2025

The use of real-world evidence among healthcare payers: a scoping review.

Lisa Masucci, Diedron Lewis, Jiahao Zhao, Caitlin Carter, Kelvin K W Chan, William W L Wong

Abstract readScoping Review
In one paragraph

Article in International journal of technology assessment in health care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lisa MasucciToronto Health Economics and Technology Assessment Collaborative, https://ror.org/026pg9j08Toronto General Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-1251-9622
Diedron LewisSchool of Pharmacy, https://ror.org/01aff2v68University of Waterloo, Waterloo, ON, Canada.
Jiahao ZhaoSchool of Pharmacy, https://ror.org/01aff2v68University of Waterloo, Waterloo, ON, Canada.
Caitlin CarterSchool of Pharmacy, https://ror.org/01aff2v68University of Waterloo, Waterloo, ON, Canada.
Kelvin K W Chanhttps://ror.org/03wefcv03Sunnybrook Health Sciences, Centre Odette Cancer Centre, Toronto, ON, Canada.
William W L WongSchool of Pharmacy, https://ror.org/01aff2v68University of Waterloo, Waterloo, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionReal-world evidence (RWE) is increasingly used to assess and make regulatory decisions on health technologies. However, its application in healthcare payer decision-making is less well-known.

objectivesThe objectives of this study were to (i) review the recent literature on how RWE has been used by healthcare payers, (ii) highlight barriers that limit the use of RWE in payer decision making, and (iii) explore how RWE has been used in various funding arrangements between payers and manufacturers. The benefits of utilizing RWE are also discussed.

methodsA scoping review was conducted on articles published between 2014 and 2025 in PubMed (Medline), OVID EMBASE, Cochrane Library, and ProQuest Dissertations and Theses Global. Eligible articles were those written in English that discussed the use of real-world evidence among healthcare payers/decision-makers for health technology reimbursement decisions.

resultsNineteen articles were selected for full-text review based on the inclusion criteria. The review highlighted payers' interest in incorporating RWE into funding and reimbursement decisions to address uncertainty in the performance of new health technologies. However, a lack of standards for collecting, analyzing, and reporting RWE limits its use. Little is known about how RWE is used in reimbursement decisions since contractual arrangements between payers and manufacturers are confidential.

conclusionsAlthough payers are interested in using RWE to inform funding and reimbursement decisions, there are concerns regarding the scientific rigor used to generate such evidence. Having more insight into the contractual arrangements between payers and manufacturers would help to better understand how RWE informs these agreements.

Indexed as

Decision MakingTechnology Assessment, BiomedicalHumansfunding arrangementspayer decision-makingpayersreal-world datareal-world evidence

Identifiers

PMID40936210
PMCPMC12450548

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.