By Angela Lawrence, Senior Director, Real World Evidence, Symphony Health, an ICON plc company
The healthcare industry sits at the center of the world’s data explosion. Nearly 30% of all global data originates from healthcare, with the compound annual growth rate (CAGR) of healthcare data expected to reach 36% in 2025. For life sciences companies, this represents both an opportunity and a challenge. More data should mean more insight—but with so many formats, sources, and limitations, the question becomes: which dataset can you truly rely on to guide your commercialisation strategy?
Historically, organisations were forced into a binary choice: use open claims for their breadth and timeliness or use closed claims for their depth and precision. Both deliver value, but both carry critical limitations. Today, however, companies no longer need to choose. By integrating open and closed claims into a unified foundation, life sciences leaders can unlock more complete, representative, and actionable insights—powering smarter decision-making across payer, patient, and prescriber needs.
Open Claims: Breadth and Speed
Open claims are collected from diverse networks, such as clearinghouses, pharmacies, and hospital systems. Because they are not tied to a specific payer or enrollment period, they offer:
- Broad patient representation, including commercial, managed Medicaid, all Medicare Types (Part A, B, C, D, and F), cash-pay, and Medicaid and Medicare fee-for-service (FFS) claims.
- Real-time availability, with minimal lag from healthcare event to dataset.
- Transparency into payer dynamics, such as cash and assistance programs not visible in closed claims.
For commercial teams, these attributes make open claims invaluable for:
- Market landscape analysis – assessing competitive positioning across geographies and patient segments.
- Patient journey mapping – tracking how patients present, are diagnosed, and initiate treatment.
- Launch uptake monitoring – seeing early prescribing trends within days or weeks of a new therapy entering the market.
- Payer Analytics – enabling market access strategy and monitoring at a granular payer name detail
Open claims come with limitations and data gaps may obscure parts of the patient journey, particularly in institutional settings. High-cost or novel therapies may be blocked from industry visibility due to manufacturer, pharmacy or payer strategies. And without enrollment data, longitudinal tracking of patients is inconsistent.
Open claims deliver speed and reach—but they are not enough alone for robust commercialisation needs.
Closed Claims: Depth and Precision
Closed claims data comes directly from payers—commercial insurers, Managed Medicare, and Managed Medicaid—and captures all enrolment details regardless of utilsation and every covered service during a patient’s enrollment. This ensures:
- Complete visibility into diagnoses, procedures, prescriptions, and costs.
- Robust longitudinal tracking during the enrolment window.
- Detailed payer evidence needs, including consumption and cost of care.
Closed claims are particularly powerful for:
- Health economics and outcomes research (HEOR) – measuring burden of disease and cost of care.
- Regulatory submissions – providing documented evidence for value and safety.
- Comparative effectiveness – assessing real-world outcomes between therapies.
However, closed claims also have limitations. Their scope is restricted to insured patients only, leaving out Medicaid and Medicare FFS, the uninsured, patient assistance programs and cash-pay populations. Data lags of 60–90 days limit their usefulness for time-sensitive analyses such as health care provider (hcp) triggers or launch tracking. And payer-specific biases may reduce representativeness across geographies and demographics.
Closed claims deliver depth and financial precision—but cannot alone represent the full market.
Integration: A Third Option
The most effective foundation is no longer a choice between open or closed. It is integrated open + closed claims.
By uniting the timeliness of open claims with the precision of closed claims, integration delivers a comprehensive dataset that addresses the needs of all three core stakeholders in commercialisation:
- Payers – Evaluate cost of care, adherence, and other utilisation patterns across payer types with reduced bias for evidence packages.
- Patients – Track initiation, persistence, and discontinuation seamlessly across enrollment periods.
- Prescribers – Understand prescribing behaviour with visibility into both blocked products and payer-influenced restrictions.
Integration also enables more advanced applications:
- Comprehensive patient journey mapping, closing gaps in care visibility.
- Population health insights, with more representative coverage across demographics.
- Cross-departmental alignment, where commercial, HEOR, medical affairs, and analytics all work from the same unified dataset.
Integration is no longer an aspirational concept. It is a foundational shift in how data informs commercialisation.
PatientSourceDUO™: Integration, Realised
Symphony Health, an ICON plc company, has brought this integrated vision to life with PatientSourceDUO™. This unique solution combines the longitudinality and breadth of open claims with the patient-level precision and depth of closed claims for a singular dataset with multiple use cases across the product lifecycle.
Key features include:
- Cleansed, deduplicated, and standardised data – ensuring analytical readiness from day one.
- Tokenisation with Synoma® – enabling secure, privacy-certified linkage across datasets.
- Longitudinal visibility – bridging patient journeys before, during, and after insurance enrollment.
- Cross-functional applicability – supporting commercial analytics, HEOR, clinical, medical affairs, real-world evidence, and regulatory needs.
PatientSourceDUO™ empowers life sciences organisations to:
- Refine payer strategy with accurate cost-of-care and utilisation insights.
- Enhance patient support by identifying points of discontinuation and tailoring interventions.
- Improve prescriber engagement with evidence-backed visibility into prescribing behaviour and their patients’ outcomes.
- Strengthen pharmacovigilance with a more complete view of long-term outcomes and safety signals.
Put simply: PatientSourceDUO™ is the commercialisation dataset that life sciences has been waiting for.
Symphony Health: Beyond the Data
Integration is powerful, but it is only part of the story. Symphony Health delivers more than a dataset—we deliver a data partnership designed for continuity, optimisation, and outcomes.
- Data strategy – Ensuring continuity across business-critical commercial functions.
- Data strength – Built on 270+ sources, with partnerships averaging 20+ years.
- Data connections – Linking 3 in 4 patients with prescriptions to diagnoses.
- Data optimisation – Tokenised integration of open and closed claims for a holistic view.
- Fit-for-purpose solutions – Tailored to unique business questions, not one-size-fits-all.
- Consulting + technology – Expertise to transform data into action.
With Symphony Health, organisations gain not just access to data, but the clarity and confidence to act on it.
Conclusion: The Future of Commercialisation is Integrated
In an industry where patient and payer access, and prescriber engagement define success, relying on incomplete datasets is no longer an option. Open claims alone provide speed and breadth but lack depth. Closed claims provide precision and depth but lack breadth. Integration delivers the best of both worlds regardless of which phase the product is in during its lifecycle. Access to the power of integrated claims through drug development, pre-commercialisation efforts, launch preparation and fully developed products will only further understanding of the patients and their journey and drive holistic and comprehensive data insights not found in any other standalone data set out in the industry.
With PatientSourceDUO™, Symphony Health enables organisations to revolutionise commercialisation—transforming data into decisions, and decisions into better patient outcomes.
Because in the end, commercialisation is not just about bringing therapies to market. It is about ensuring they reach the right patients, supported by the right evidence, at the right time. And that requires an integrated foundation.
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