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 a series that’s revealed how differently payers around the world are grappling with shared challenges.

About The Payer Exchange

The Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets.

The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.

The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.

Disclaimer

This podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.

In this episode, I speak with Professor 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 offers a Dutch perspective on balancing economic realism with equity and innovation.

About The Payer Exchange

The Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets.

The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.

The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.

Disclaimer

This podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.

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, with real-world insights from someone deeply embedded in both policy and practice.

About The Payer Exchange

The Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets.

The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.

The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.

Disclaimer

This podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.

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 negotiate from “the dark side” and get a glimpse into a payer mindset shaped by pragmatism, experience, and a few unexpected views.

About The Payer Exchange

The Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets.

The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.

The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.

Disclaimer

This podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.

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 Europe’s most closely watched pricing systems.

About The Payer Exchange

The Payer Exchange is a podcast where Omar Ali, Head of Payers at Verpora, sits down with payers from around the world to talk candidly about what’s shaping access, value, and decision-making in their markets.

The series covers a range of consistent themes across markets—such as horizon scanning, indication-based pricing, rare diseases, and system sustainability—while also highlighting country-specific dynamics. By asking the same core questions in each conversation, the podcast reveals both common pressures and contrasting approaches across healthcare systems.

The Payer Exchange is designed for professionals working in market access, pricing, policy, and strategy who want a deeper understanding of how payers are approaching the increasingly complex landscape of pharmaceutical innovation.

Disclaimer

This podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.

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 trends, and how payer thinking is evolving—from horizon scanning to contracting, regulatory reform to real-world evidence.

This isn’t a panel. It’s not a pitch. It’s a chance to hear what’s really happening—straight from the people who live it.

Subscribe now to join me for global voices, local insights, and real talk on the future of access.

Disclaimer: This podcast is for educational and informational purposes only, and is not intended as legal or policy advice. All content is based on non-confidential intelligence. Views expressed by the speakers are personal opinions and should not be attributed to anyone else. No part of this presentation may be reproduced for commercial purposes without the express permission of Omar Ali, Verpora Limited.