The Payer Exchange

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...

In this opening episode, Omar Ali is joined by Dr Yousaf Ahmad, 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 paye...

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...

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 a...

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 as...

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, wh...

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...

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...

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 contr...

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 ar...

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 tran...

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...