(Some) drugs are expensive. True. (Some) single-payer systems are struggling financially. True. Access to leading-edge products can be a challenge for patients in many healthcare environments. Also true. Reuters got hold of a roadmap from the European Federation of Pharmaceutical Industries and Associations (EFPIA) that discusses a plan that sounds a lot like pay-for-performance. Francois Bouvy, Director of Market Access at EFPIA, wrote “If a product does not deliver on its clinical promise, society should not continue to pay for it. Equally, if the product delivers more value than was ever expected, this extra value must be rewarded.” Here is EFPIA’s response. Eventually, something like this has to happen, right? Look for more RWD/RWE to be accounted for in clinical trial protocols and certainly come post-approval. Yay, HEOR!