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Rising drug spending and increased desire for expenditure controls are consistent themes across the US, Europe, and emerging markets. With governments and private healthcare systems under increasing pressure to fund high-cost, innovative therapies, which often launch with limited clinical trial evidence, payers are looking towards new and enhanced reimbursement processes which align drug funding with patient value. Based on these growing demands, the healthcare policy environment remains fluid, with payers introducing increasingly restrictive cost-control mechanisms in order to limit the burden on constrained healthcare budgets. For pharmaceutical manufacturers, success will require increasing flexibility on price and the ability to adapt to new access scenarios brought about by changing access dynamics and geographical differences.