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Beyond Claims and EHR: The Untapped Potential of Patient-Reported Outcomes

April 23, 2025

In the world of pharmaceutical R&D, claims data and electronic health records (EHR) have long been the go-to sources for real-world evidence (RWE). But these data sources only tell part of the story. To truly understand the patient experience, you need patient-reported outcomes (PROs)—the unfiltered insights shared by patients about their symptoms, treatments, and quality of life.

At Inspire, we’ve seen how PROs can transform RWE by providing a deeper, more nuanced understanding of patient experiences. Here’s why PROs matter and how you can leverage them to enhance your R&D efforts:

1. The Limitations of Claims and EHR Data

Claims and EHR data are valuable, but they have significant limitations:

  • Limited context: These data sources capture what happened (e.g., a diagnosis or prescription) but not why it happened or how the patient felt about it.
  • Incomplete picture: Claims and EHR data often miss important aspects of the patient experience, such as symptom severity, treatment adherence, or quality of life.
  • Lagging indicators: These data sources are retrospective, making it difficult to capture real-time insights or emerging trends.

For example, claims data might show that a patient filled a prescription, but it won’t tell you whether they experienced side effects or stopped taking the medication.

2. The Power of Patient-Reported Outcomes

PROs fill these gaps by capturing the patient perspective in their own words. These insights allow you to:

  • Understand the full patient journey: Learn about symptoms, treatment experiences, and daily challenges that aren’t captured in claims or EHR data.
  • Identify unmet needs: Discover gaps in care or areas where patients need more support.
  • Measure what matters to patients: Focus on outcomes that patients care about, such as symptom relief, quality of life, or treatment satisfaction.

For instance, multiple sclerosis patients might report that fatigue is their most debilitating symptom—a critical insight that claims data alone wouldn’t reveal.

Claims and EHR data capture what happened—PROs explain why it mattered.

3. How PROs Enhance Real-World Evidence

PROs add a critical layer of context to traditional RWE, enabling you to:

  • Complement claims and EHR data: Combine quantitative data with qualitative insights for a more comprehensive view.
  • Support regulatory submissions: Provide evidence of patient-centered outcomes that strengthen your case with regulators.
  • Inform product development: Use patient feedback to design better trials, refine endpoints, and develop more effective treatments.

For example, if diabetes patients report that a new injectable medication is difficult to use, your R&D team can explore alternative delivery methods.

4. Leveraging PROs for Market Access

PROs are also a powerful tool for market access and payer negotiations. By demonstrating the real-world impact of your product, you can:

  • Show value to payers: Provide evidence that your product improves patient outcomes and quality of life.
  • Support value-based pricing: Use PROs to justify the cost of your product based on its benefits to patients.
  • Build trust with stakeholders: Show that your decisions are grounded in real patient experiences.

For instance, if asthma patients report significant improvements in symptom management after using a new inhaler, this data can strengthen your case with payers.

5. How Inspire Delivers PROs

Inspire’s platform connects you with millions of patients in condition-specific communities, providing access to real-time, actionable PROs. Here’s how we help you leverage this data:

  • Data linkage: Combine PROs with claims, EHR, and other sources for a comprehensive view of the patient experience.
  • AI-powered analytics: Use advanced tools to analyze trends, identify patterns, and generate insights.
  • Custom research: Conduct surveys, focus groups, or interviews to gather targeted feedback.

For example, a pharmaceutical company developing a new rheumatoid arthritis treatment could use Inspire’s platform to gather PROs on symptom severity, treatment satisfaction, and quality of life.

Conclusion

Patient-reported outcomes are a game-changer for R&D. By capturing the real, unfiltered experiences of patients, you can enhance your RWE, drive patient-centric drug development, and strengthen your case with regulators and payers.

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