The COVID-19 pandemic has revealed the broad and devastating health, economic and societal impact of a highly infectious and deadly disease. In addition to the human suffering of COVID-19 patients, the pandemic is taking a heavy toll patients’ families, friends, colleagues, and other social networks. On healthcare staff working around the clock, wave after wave. And on the capacity of the NHS, buckling under the pandemic pressures with consequences that will last for years. Then, there’s the disastrous economic impact, crippling economies in the UK and worldwide.
Towse, A., Lothgren, M., Steuten, L. and Bruce, A.
Using medicines in combination can deliver better outcomes for patients across different tumour types and disease stages. Yet many HTA agencies do not find that the expected additional benefits from adding a new medicine to a currently reimbursed medicine represents value for money to the health system. In markets that utilise cost-per-QALY approaches for assessing value, a clinically effective medicine might even be found to be “not cost-effective at zero price” when used as part of a regimen that increases treatment duration.
Histology independent therapies, a new class of medicines that target cancer based on specific genomic or molecular alterations of cancer cells rather than tissue of origin, face significant methodological and policy hurdles related to evidence development and acceptance, value assessment and reimbursement pathways, and diagnostic infrastructure availability.
This paper presents a supply and demand model of pharmaceutical markets to analyse the relationship between the value of the Cost-Effectiveness Threshold (CET) and the distribution of the health and economic value of new medicines between consumers (payers) and developers (life science industry). As a novelty, the model incorporates a bargaining process and bargaining power distributed between the payer and the developers, which has an impact on the distribution of the health and economic value of new medicines between the two parties.
Most value assessments of vaccination programs are carried out by taking the perspective of the health system. To stimulate the debate concerning the broader value of vaccination beyond this perspective, this report quantifies the related return on investment to the UK government.
Brassel, S., Neri, M., O’Neill, P. and Steuten, L.
Many health technology assessment (HTA) agencies limit their assessment of vaccines to individual health benefits and the costs associated with vaccine administration and the disease avoided. However, compared to other health technologies, the standard evaluation approaches have often been criticised as inadequate to accurately estimate the value of vaccines.
The National Institute of Health and Care Excellence (NICE) makes recommendations for the use of interventions including medicines in the National Health Service in England based on their clinical and cost-effectiveness. Over the last 20 years 82% of technology appraisal recommendations have been ‘positive’. However, around one third of these are ‘optimised’ recommendations. In this report we quantify the patient access associated with NICE ‘optimised’ recommendations.
In the 2017 Industrial Strategy, the Government committed to increasing investment in UK Research and Development to the OECD-average of 2.4% of Gross Domestic Product (GDP) by 2027, with a longer-term goal of reaching 3% to put the UK in the upper quartile. Whilst there is universal agreement that increasing R&D investment in the UK is a worthy goal, there is an ongoing discussion over how best to achieve it.
OHE presents an overview on the use of cost-effectiveness thresholds (CETs) in a number of selected countries in their decision-making process for health technology assessments. In addition to the different levels of CETs in these countries, this review examines whether an explicit or implicit CET is used, and the additional considerations (here termed ‘modifiers’) that are incorporated when funding and reimbursement decisions are made.
Errea, M., Skedgel, C., Zamora, B., G, Hampson., R, Althin., Hofmarcher, T., Lindgren, P., & Cookson, G.
Substantial economic resources are devoted to healthcare across Europe, but there is evidence that a large proportion of these resources are of limited benefit to patients and society. Around 10% of European Gross Domestic Product (GDP) is spent on healthcare and estimates suggest that as much as one-fifth of this amount (2% of GDP) is spent on interventions that make no meaningful contribution to health outcomes. In economic terms, these resources are used inefficiently.