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.
In the final episode of Season 3, Omar Ali speaks with Ross Margulies of Manatt Health about the policy and legal changes reshaping US pharmaceutical pricing and their consequences far beyond the United States. They discuss Most Favoured Nation (MFN) and international reference pricing, GUARD and GLOBE, the legal durability of current reforms, the move to formal CMS rulemaking, Part B medicines and provider incentives. Ross also explains why manufacturers are already rethinking launch sequenc...
16 Sept 2026
E13: USA - Matt Harman
Continuing the US-focused series, Omar Ali speaks with Matt Harman, VP of Clinical Solutions at Employers Health, bringing an employer-sponsored health plan perspective to questions of affordability, access and benefit sustainability. They discuss commercial spillover from Medicare reforms, specialty pipeline risk, medical benefit visibility, biosimilars, GLP-1 affordability and the changing role of Pharmacy Benefit Managers (PBM)s. Matt explains how Employers Health works with self-insured e...
9 Sept 2026
E12: USA - Drake Reiter
In Episode 12, Omar Ali speaks with Drake Reiter, Director of Pharmacy Operations at Priority Health, about how a regional US health plan is thinking about the next phase of pricing and contracting reform. They discuss Most Favoured Nation (MFN), the Inflation Reduction Act (IRA) and Pharmacy Benefit Manager (PBM) reform, the gradual erosion of rebate-led contracting, commercial spillover from Medicare Most Fair Pricing (MFPs), transparency, formulary leverage and whether a different definiti...
2 Sept 2026
E11: USA - Jill Hanson
Launching Series 3 of The Payer Exchange’s special US focus, Omar Ali speaks with Jill Hanson, VP of Regional Pharmacy at Centene Pharmacy Services, who brings a specialty pharmacy perspective to changes in drug pricing, contracting and medical benefit management, from one of the largest Medicaid managed care organisations in the US. The conversation covers MFN, GUARD and GLOBE, the shift away from rebate maximisation, high-cost therapy forecasting, Part B pricing and site-of-care opti...
27 Aug 2026
Season 3 Trailer: USA Special
What happens when the world’s largest pharmaceutical market fundamentally changes the way it pays for medicines? As US policy evolves around Most Favoured Nation pricing, the Inflation Reduction Act, CMS drug price negotiations and international reference pricing, the consequences could influence launch sequencing, commercial strategy and patient access around the world. Season 3 of The Payer Exchange has a special US focus, bringing together complementary perspectives from specialty pharmacy...
28 Nov 2025
E10: Saudi Arabia - Abdulrazag Al-Jazairi
In the final episode of the series, Omar speaks with Dr Abdulrazag Al-Jazairi, Advisor to the Saudi Food and Drug Authority, about the rapidly evolving payer and HTA environment in Saudi Arabia. They discuss what it means to develop payer infrastructure from the ground up, the influence of international frameworks on domestic decision-making, and how value-based agreements are beginning to play a role in national pricing strategy. Key themes: HTA system development in Saudi ArabiaLocal adapta...
27 Nov 2025
E9: Belgium - Lieven Annemans
Omar is joined by Professor Lieven Annemans, former chair of Belgium’s health economics advisory committee, to explore the complexities of European HTA policy. They talk about the role of Joint Clinical Assessment (JCA), the risk of over-assessment in policy design, and the challenge of maintaining local relevance within a harmonised EU framework. Lieven brings perspective on how the purpose of assessment is sometimes lost in the process of implementation. Key themes: Joint Clinical Assessmen...
27 Nov 2025
E8: Canada - Don Husereau
In this episode, Omar speaks with Canadian health economist and policy advisor Don Husereau about Canada’s unique payer landscape. Don isn’t your typical policy analyst. He’s worked in HTA, advised governments, and written widely about the gaps, flaws, and hidden logic in pricing systems like Canada’s. They discuss the decentralised nature of decision-making, the gap between evidence generation and clinical practice, and the disconnect between how healthcare science is developed versus ...
27 Nov 2025
E7: Poland - Krzysztof Łanda
Omar speaks with Dr Krzysztof Łanda, former Deputy Minister of Health, health economist, and someone who’s helped shape the pricing and HTA landscape in Poland over the past two decades. They examine the influence of external pricing references, the practical realities of MFN implementation, and the state of HTA reform. The discussion also covers the potential role of JCA and how manufacturers can adapt to a system that combines political oversight with economic rigor. Key themes: External re...
27 Nov 2025
E6: UK - Yousaf Ahmad
In this opening episode, Omar Ali is joined by Dr Yousaf Ahmed, Chief Pharmacist and Director of Medicines Optimisation at a NHS Integrated Care System. They explore the practical trade-offs being made inside the NHS today: the pressure to find efficiency without losing sight of quality, the reality of navigating oncology value frameworks, and the challenge of ensuring that VBAs work for both payers and manufacturers. The conversation also touches on the UK’s evolving approach to MFN spillove...
25 Nov 2025
Series 2 Trailer
What happens when the world’s pricing pressures start reshaping national systems from the inside? In Season 2 of The Payer Exchange, we speak to former payers and policy leaders from five different countries—each responding to the same global trends in very different ways. From MFN spillover to combination oncology, from HTA reform to value-based agreements, we look at how systems are adapting, what’s working, and where the pressure is still building. Guests this season include: 🇬🇧 Yousaf ...
8 Jul 2025
E5: Spain - Jaime Espín
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...
8 Jul 2025
E4: Netherlands - Hans Serverens
In this episode, I speak with 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 offer...
8 Jul 2025
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, w...
8 Jul 2025
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 negot...
8 Jul 2025
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 ...
7 Jul 2025
Series 1 Trailer
What really shapes access decisions in healthcare? Beyond the policy documents and headlines—it’s the people. The payers making the calls. I’m Omar Ali, and The Payer Exchange is a podcast where I sit down with payers from around the world for honest, unscripted conversations about what’s really driving decisions on drug pricing, access, and reimbursement. Each episode, I speak to someone working at the heart of healthcare funding in their country. We talk about the local challenges, global t...
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