• Biosimilars
  • Drug Development/R&D
  • All Topics
OHE OHE
Newsletter SignupSubscribe

News & Insights
  • News
  • Events
  • Insights
  • Bulletin
  • News
  • Events
  • Insights
  • Bulletin

News & Insights

  • News
  • Events
  • Insights
  • Bulletin
Newsletter SignupSubscribe
  • News
  • Events
  • Insights
  • Bulletin

Close
OHE OHE
  • Research & Publications
  • News & Insights
  • Education
  • Innovation Policy Prize
  • Events
  • About Us
  • OHE Experts
  • Contact Us
Newsletter SignupSubscribe

Research & Publications

All Publications

Filter by:
  • Antimicrobial Resistance (AMR)
  • Biosimilars
  • Cell and Gene Therapies
  • Chronic Diseases
  • Combination Therapies
  • COVID-19 Research
  • Digital Health
  • Drug Development/R&D
  • Emerging Markets
  • EQ-5D and PROMs
  • Health Care Systems
  • Health Data and Statistics
  • Health Technology Assessment
  • Precision Medicine
  • Real World Evidence
  • Use of Medicines
  • Value-Based Pricing
  • Vaccine Research
  • Economics of Innovation
  • Measuring and Valuing Outcomes
  • Policy, Organisation and Incentives in Health Systems
  • Value, Affordability and Decision Making

News & Insights

  • News
  • Events
  • Insights
  • Bulletin

Education

  • Education Hub
  • OHE Graduate School
  • EVIA Programme

Innovation Policy Prize

  • The Prize Fund
  • 2022 Prize Fund

Latest Research & Publications

  • Antimicrobial Resistance (AMR)
  • Economics of Innovation

Incentivising New Antibiotics: Designing a Value-Based Delinked Pull Incentive Mechansim

Men rowing on a river
Read more

Proposal for a General Outcome-based Value Attribution Framework for Combination Therapies

CombTher_Adobe_photoguns_portrait
Read more
© photoguns
  • Digital Health

Navigating the Landscape of Digital Health – United Kingdom

Healthcare_Adobe_elenabsl
Read more

2021 OHE Annual Report to the Charity Commission

charityreport_lina-trochez-unsplash_landscape
Read more
© Lina Trochez/Unsplash

Supporting the Era of Green Pharmaceuticals in the UK

Sustainability_AdobeStock_270582392_landscape
Read more

Quality of life and wellbeing in individuals with experience of fertility problems and assisted reproductive techniques

Quality of life assisted reproduction Cover
Read more
  • Cell and Gene Therapies
  • Value, Affordability, and…

Health Technology Assessment of Gene Therapies: Are Our Methods Fit for Purpose?

gene_therapies_national-cancer-institute-unsplash_landscape
Read more
© NCI/Unsplash
  • Drug Development/R&D
  • Economics of Innovation
  • Health Policy and Regulation

Limitations of CBO’s Simulation Model of New Drug Development as a Tool for Policymakers

CBO-US_mayer-tawfik-K4Ckc0AxgDI-unsplash_landscape
Read more
© Mayer Tawfik/Unsplash
Close
OHE
  • All Publications

    Filter by:
    • Antimicrobial Resistance (AMR)
    • Biosimilars
    • Cell and Gene Therapies
    • Chronic Diseases
    • Combination Therapies
    • COVID-19 Research
    • Digital Health
    • Drug Development/R&D
    • Emerging Markets
    • EQ-5D and PROMs
    • Health Care Systems
    • Health Data and Statistics
    • Health Technology Assessment
    • Precision Medicine
    • Real World Evidence
    • Use of Medicines
    • Value-Based Pricing
    • Vaccine Research
    • Economics of Innovation
    • Measuring and Valuing Outcomes
    • Policy, Organisation and Incentives in Health Systems
    • Value, Affordability and Decision Making
    • News
    • Events
    • Insights
    • Bulletin
    • Education Hub
    • OHE Graduate School
    • EVIA Programme
    • The Prize Fund
    • 2022 Prize Fund
  • Events
  • About Us
  • OHE Experts
  • Contact Us
Newsletter SignupSubscribe
Back
  • Insight
11 min read 22nd June 2021

Towards a New Understanding of Unmet Medical Need

In a commentary piece recently published in Applied Health Economics and Health Policy, OHE authors discuss how the misalignment in interpretations of the term ‘unmet medical need’ by different stakeholders has led to insufficient incentives for development in areas with…

Share:
  •  Twitter
  •  LinkedIn
  •  Facebook
  • has-icon Email
Fig1-2

In a commentary piece recently published in Applied Health Economics and Health Policy, OHE authors discuss how the misalignment in interpretations of the term ‘unmet medical need’ by different stakeholders has led to insufficient incentives for development in areas with urgent, genuine need, and propose a new framework for developing a more consistent understanding of UMN that will increase innovation.

In a commentary piece recently published in Applied Health Economics and Health Policy, OHE authors discuss how the misalignment in interpretations of the term ‘unmet medical need’ by different stakeholders has led to insufficient incentives for development in areas with urgent, genuine need, and propose a new framework for developing a more consistent understanding of UMN that will increase innovation.

The term ‘unmet medical need’ (UMN) is often used to signal special priority for treatments that address pressing medical needs. However, the understanding of UMN is often context-specific, leading to a lack of alignment in the way it is interpreted by different stakeholders (including public research funders, health regulators, and health technology assessment (HTA) agencies) in terms of priority-setting. A review by Vremen et al. (2019) found 16 different operational definitions of UMN, many of which differed in substantive respects. A shared understanding of what constitutes an UMN is critical to providing a consistent and reliable signal to innovators, thus such misalignment has arguably been a barrier to innovation in areas of genuine medical need.

At its essence, UMN is meant to distinguish more urgent societal health needs from those that are less urgent. As a first step in addressing this misalignment, we propose a conceptual framework based on principles of distributive justice as a means of developing a shared understanding of objectives around UMN. Central to this approach is recognising that stakeholders can identify a set of rationale, based on a shared vision of ‘fairness’, upon which a set of principles for priority-setting might be agreed.

Figure 1 below presents an illustration of the way by which various principles – e.g. concern for need, inequality, and wellbeing maximisation – relate to the various elements of UMN described in the review by Vreman et al. (2019) – including aspects of availability, disease burden, and patient characteristics. This is not to imply that these are the only principles relevant to understanding UMN, and different readers may see different principles reflected in different elements of UMN. These are only intended to serve as a starting point for discussion. Any process of reconceptualising UMN must be stakeholder-led to achieve consensus over identified principles.

Figure 1. Illustration of key principles within elements of unmet medical need

A key challenge here is that these principles represent often conflicting concerns (e.g. the incompatible objective of simultaneously equalising and maximising outcomes. Hence, trade-offs must be made between objectives, and different stakeholders may assign a different degree of importance to each objective. Discussing differing priorities and objectives at the level of principles rather than quantitative criteria (e.g. ‘a need is only ‘unmet’ if there are no available alternatives’) allows stakeholders to consider these trade-offs in a more constructed manner than is possible under the often binary and disconnected criteria by which UMNs are currently understood.

Agreeing on a principles-based framework will not in itself provide an operational definition of UMN However, it is an important initial step towards reconceptualising UMN to improve alignment between stakeholders, and in turn, providing a more reliable and consistent signal to innovators.

References

Vreman RA, Heikkinen I, Schuurman A, et al. Unmet medical need: an introduction to deinitions and stakeholder perceptions. Value Health. 2019; 22:1275–82. https://doi.org/10.1016/j.jval.2019.07.007

Citation

Zhang, K., Kumar, G. & Skedgel, C. Towards a New Understanding of Unmet Medical Need. Appl Health Econ Health Policy (2021). https://doi.org/10.1007/s40258-021-00655-3

  • Drug Development/R&D
  • Policy, Organisation and…
  • External Publications

Related Insights

Slide3
  • Insight
  • October 2022

The Economics of Antibiotics – Part 3: Creating a Healthy Global Market for New Antibiotics

Read more
HealthData&Stats_AdobeStock_168196575_landscape
  • Insight
  • August 2022

Improving the Measurement of Valued Output in Primary Care in England

Read more
Good and Broken Light Bulb
  • Insight
  • July 2022

Reforming Primary Health Care in Middle-Income Countries: The Good, the Bad, and the Ugly

Read more
PatientPayer_Adobe_missizio01-scaled-1
  • Insight
  • June 2022

The Benefits of Early Engagement with Payers and Patient Representatives: The Case Study of a MoCA Pilot Project on ANCA-associated Vasculitis

Read more
footer_ohe_logo

Leading intellectual authority on global health economics

Sign Up for the OHE News Bulletin

Newsletter SignupStart Sign Up

Research & Publications

News & Insights

Innovation Policy Prize

Education

Events

About Us

OHE Experts

Contact Us

Sign Up for the OHE News Bulletin

Newsletter SignupStart Sign Up

The Office of Health Economics (OHE) is a company limited by guarantee registered in England and Wales (registered number 09848965) and its registered office is at 2nd Floor Goldings House, Hay’s Galleria, 2 Hay’s Lane, London, SE1 2HB.

Terms & Conditions

Privacy Policy

Cookies Policy

© 2023 Website Design

An error has occurred, please try again later.An error has occurred, please try again later.

We are using cookies to give you the best experience on our website.

You can find out more about which cookies we are using or switch them off in settings.

 Twitter
 Facebook
 LinkedIn
 Copy
 Email
Powered by  GDPR Cookie Compliance
Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookies

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.

3rd Party Cookies

This website uses Google Analytics to collect anonymous information such as the number of visitors to the site, and the most popular pages.

Keeping this cookie enabled helps us to improve our website.

Please enable Strictly Necessary Cookies first so that we can save your preferences!