The real weight of real-world data: Key factors for successful real-world data RFP/RFI

Author:

Connie Inguanti

President, Symphony Health, an ICON plc company

In healthcare, numbers carry weight—sometimes literal, sometimes legal, always clinical.

For life sciences companies making high-stakes decisions, the risk of getting it wrong is even greater. Choosing the right real-world data (RWD) partner to support a post-marketing study or gauge the uptake of your next drug product can make or break a program. This is especially true given the increased number of available data suppliers in recent years, meaning there are more choices in supplier and more variables in approaches and datasets. It’s critical to ensure that the numbers carry the right weight.

In this blog, we outline a few key considerations to help design RFIs/RFPs and assess supplier responses to improve the decision-making process.

Complicated counts: Data supplier scenarios

Imagine this scenario: A company receives two responses to an RFP designed to gauge the availability of RWD specific to a rare disease patient population over a 5-year period.

Supplier A reports 2 million claims in their repository
Supplier B reports 1.2 million claims in their repository

Assuming similar price proposals, Supplier A appears to offer 67% more claims—an ROI that’s significantly higher than apparently offered by Supplier B. Based on that assessment, Supplier A seems to be the best option.

But here's the critical question that needs to be addressed: Are these counts even equivalent between the two suppliers?

What sponsors need to know when choosing RWD suppliers

Here are two key factors to consider when comparing supplier responses to RFIs/RFPs to ensure the right fit and the most return on investment in RWD:

1. Compare how suppliers define claims

In the scenario above, if Supplier A’s repository maintains the original structure of a claim while Supplier B’s repository assigns a claim ID to a unique combination of fields (e.g., provider and service date combinations for each patient), then this will undoubtedly contribute to disparities in counts reported in RFIs/RFPs.

Recommendation: Consider including a definition or requesting that each supplier explain their definition of a claim as part of the RFI/RFP. This will help determine whether counts are equivalent between suppliers and inform the contracting decision.

2. Understand how suppliers qualify claims

Many RFIs/RFPs contain qualifying diagnosis codes for segmenting specific therapeutic areas or patient populations of interest. In professional claims¹(837-P), diagnosis codes are reported in two places:

at the claim level (up to 12 are reported, not in order of precedence)
at the service line level (up to 4 are reported and must be in order of precedence for each service or procedure reported; referred to as “pointers”)

It is the latter type of diagnosis code that is best used to qualify whether a service or procedure was in the treatment of a given disease or condition. Differences between supplier qualification methods will also contribute to disparities in counts reported in RFIs/RFPs.

Recommendation: Consider indicating which type of diagnosis codes that each supplier should qualify with when reporting claim counts for professional claims to ensure equivalency between suppliers.

Opacity is the red flag, not variance

Variance in data is normal, even necessary. It reflects an evolving ecosystem. But when changes go unexplained and data transparency is lacking, confidence erodes—and that’s a far greater risk to overall strategy.

When evaluating real-world data suppliers, ask suppliers to clearly explain both their claim definitions and their qualification methods to ensure the comparisons are informed and equivalent. Including this as part of an RFI/RFP will create more transparency earlier in the evaluation process.

Choose a partner, not a dataset

At Symphony Health, an ICON plc company, we often field questions around RWD supplier selection during procurement cycles or advisory discussions. And while the answers are rarely simple, they should always be transparent. No matter the stage of development, from developing a clinical strategy, refining market access forecast, or benchmarking outcomes, trustworthy data is imperative. Understanding the factors behind counts and the weight of the data being evaluated will deliver better decisions around data requirements and partner selection to support overall goals.

Connect with us to learn more about RWD and the supplier selection process.

¹Note: This does not apply to institutional (837-I) claims.