This article in ISMPPs May newsletter got me thinking about the way we evaluate literature. If we agree that there is a need to redefine the importance and focus of systematic literature reviews, don’t we also need to reevaluate the literature at the top of the evidence pyramid? I agree that not all evidence is created equally, but surely we should be putting a greater emphasis on patients' experience/voice when focussing on payers and regulators as the target audience.