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.
Although the science underlying drug development has evolved, there has been little change in how we pay for them. As more and more medicines come to market with multiple indications (or even more importantly the unrealised potentialto treat multiple indications), the way we pay for those medicines becomes critical in making sure we can benefit from them. “Indication-based pricing” (IBP) permits price to vary according to indication and has been proposed to tackle this issue.
Hernandez-Villafuerte, K., Shah, K., Herdman, M., and Lorgelly, P.
Meningococcal disease is a life-threatening infection and can result in severe sequelae. Recent scientific and technical advances have led to the discovery and implementation of novel meningococcal vaccines which have resulted in a substantial reduction in the burden of disease worldwide, representing a major public health achievement (Crum-Cianflone and Sullivan, 2016).
Cubi-Molla, P., Errea, M., Zhang, K. and Garau, M.
Cost-Effectiveness Thresholds (CETs) are used in a selected number of countries as tool in decision-making on funding and reimbursements for new healthcare technologies. In this white paper, OHE presents an analysis of the relative merits and shortfalls of current approaches to defining, estimating and applying CETs in Health Technology Assessments. The paper also puts forward a number of policy recommendations to help guide decision makers in ensuring CETs are used to achieve improved health outcomes in the future.
Henderson N., Errea M., Skedgel C. and Jofre-Bonet, M.
In light of concerns that not all medicines for ultra-rare (also known as ultra-orphan) conditions are appraised under the same NICE process, a new OHE Consulting Report discusses the distinct ethical and economic challenges faced by medicines for ultra-rare conditions, with particular reference to the challenges of HTA in the UK. A failure to consistently consider all ultra-rare disease medicines under the HST process could lead to inequalities in access and health outcomes for patients with ultra-rare conditions.