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AI is no longer just something US payers are talking about. It’s something they’re actively building into how they work.

Our team was pleased to present “US Payer Current and Future Adoption of Artificial Intelligence.” Our research at ISPOR on how payers are using AI today and where adoption is headed next. What stands out most is that AI use is already gaining traction in areas like prior authorization, population health analytics, claims processing, fraud detection, and member engagement, with even broader use expected over the next 3 years.

As payer AI capabilities mature, the way organizations generate evidence, communicate value, and engage with payer stakeholders will need to evolve too. Strong data, governance, and operational readiness will be critical.

In oncology HEOR, the methodological choices behind a cost-effectiveness estimate can shape decisions long before mature clinical data are available.

This poster presents a modular oncology reference model for early economic evaluation, demonstrated through a HER3-DXd case study in EGFR-mutated NSCLC. The model-derived progression-free survival hazard ratio closely matched the subsequent Phase 3 result, supporting the value of structured early-phase modeling to inform pricing, evidence generation, and payer engagement earlier in development.

As the Kingdom of Saudi Arabia (KSA) implements new health technology assessment (HTA) requirements, understanding how economic evaluations may influence future pricing and reimbursement decisions is becoming increasingly important. This poster explores early perspectives from KSA formulary decision-makers on the anticipated role of HTA in market access, with a particular focus on rare diseases.

Findings suggest that cost-effectiveness, disease burden, comparative effectiveness, and local evidence are expected to be key drivers of decision-making under the new framework. The research highlights the growing importance of early evidence planning and local data generation as manufacturers adapt to KSA’s evolving value-based healthcare environment.