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Health insurers have raised challenging questions about how drugs for rare diseases are defined, regulated, and priced in the U.S. market. To learn more, Syneos Health conducted in-depth interviews with pharmacy and medical directors at health plans representing 47.2 million covered lives, then asked our internal research leaders and communications experts to respond to payers’ concerns. We looked specifically at how trends in scientific discovery, real world evidence and value-based contracts might help calm tensions over the most divisive issues. The juxtaposed viewpoints in this report show how innovation is poised to change the game.