Drug developers and regulators are rapidly expanding the use of real-world evidence to develop rare disease therapies, but a new report finds payers are far less enthusiastic about incorporating such data in evaluating the value of therapies. The report from Syneos Health found payers have concerns about a lack of standards and have gaps in their understanding. We spoke to Meg Alexander, head of the reputation and risk management practice for Syneos Health, about the report, the important role real-world evidence can play in rare disease drug development, and why payers are moving slower than drug developers and regulators to embrace real-world evidence.