Hernandez-Villafuerte, K., Zamora, B., Feng, Y., Parkin, D., Devlin, N. and Towse, A.
Estimating a cost-effectiveness threshold reflecting the opportunity cost of adopting a new technology in a health system is not easy. This OHE research paper provides empirical evidence on the relationship between health outcomes and health expenditures in England. Results suggest that setting a cost-effectiveness criterion for NICE may not be capable of being synthesised using scientific methods alone, but involve political judgements.
Cole, A., Towse, A., Segal, C.S., Henshall, C. and Pearson, S.D.
OHE Research Paper 19/02: The combination of rising drug costs in the US and increasing financial stress for individual patients has triggered intense national concern. One target has come under particular scrutiny: rebates. This paper describes how alternatives to the current US rebate system offer potential risks or disadvantages as well as potential benefits. It outlines the evidence presented to date, and the key questions that still need to be answered.
Cole, A., Cubi-Molla, P., Pollard, J., Sim, D., Sullivan, R., Sussex, J. and Lorgelly, P.
OHE Research Paper 19/01: This report explores the feasibility of introducing one type of flexible payment mechanism –outcome-based payment (OBP) –for cancer medicines into the NHS in England. This model links the price the NHS pays for a medicine to the outcomes it achieves in practice for NHS patients. OBP could help to accelerate patient access to some new medicines and ensure close monitoring of real-world patient benefit. It can also promote value for money in NHS spending and support innovation. This is especially valuable against the backdrop of rising overall NHS spending on medicines.
Hernandez-Villafuerte, K., Zamora, B. and Towse, A.
This OHE Research paper by Karla Hernandez-Villafuerte, (German Cancer Research Center, DKFZ), Bernarda Zamora (OHE) and Adrian Towse (OHE) sets out a research agenda proposing new approaches in three areas to improve understanding of supply side opportunity costs for the English NHS. A subsequent paper will set out the authors research findings.
Berdud, M., Garau, M., Neri, M., O'Neill, P., Sampson, C. and Towse, A.
Using a multidisciplinary methodological approach combining a theoretical economic framework with uptake/market share analyses by country and interviews, this OHE research concludes that: (i) IP incentives for R&D may have encouraged a high degree of in-class competition of DAAs close to the first entrant launch; (ii) in-class competition had a positive impact on uptake and adoption of DAAs in the top-5 European countries and; (iii) although in-class competition is a necessary condition for early adoption and fast uptake of innovative medicines, it is not sufficient as there are other factors related to the performance of the new technology, characteristics of the healthcare system and political factors which can have an effect.
The high cost of drugs for rare diseases (‘orphan drugs’) has generated considerable debate. While there is debate in the economic literature over whether a premium should be paid for ‘rarity’, these drugs are reimbursed with high prices in many countries. The question then arises as to what should be a reasonable price for an orphan drug?
Cole, A., Towse, A., Lorgelly, P., and Sullivan, R.
The current system of a single price per medicine means that, for multi-indication medicines, the relationship between price and “value” can vary substantially. In this OHE Research paper, we consider: What are the economic implications of an alternative to single-price payments for pharmaceuticals? In particular, what are the implications for: payer budgets, patient access, and the incentives for innovation?
Pearson, S., Dreitlein, B., Towse, A., Hampson, G. and Henshall, C.
OHE Research Paper 18/02: Real World Evidence (RWE) – This paper provides a framework and specific steps to help both manufacturers and payers meet the challenge of developing observational RWE through a transparent process that can be considered credible by all stakeholders.
Hampson, G., Towse, A., Dreitlein, B., Henshall, C. and Pearson, S.
OHE Research Paper 18/01: This paper sets out the potential opportunities and important challenges and limitations that must be addressed in considering options for using RWE to inform insurer coverage decisions. The primary purpose of developing the paper was to stimulate discussion at the 2017 ICER Policy Summit meeting. A separate paper is available that summarises the authors reflections and proposed ways forwards based on the discussions that were had at the meeting.
Zamora, B., Parkin, D., Feng, Y., Bateman, A., Herdman, M., and Devlin, N.
This paper reports new methods for analysing the distribution of EQ-5D observations. The Health State Density Index and Health State Density Curve are used to summarise the extent to which people’s self-reported health on the EQ-5D is concentrated on a few health states, or distributed more evenly over a wide range of health states. This information can be useful in understanding patients’ treatment needs, as well as providing a way of comparing the nature of data provided by different patients or collected using different patient-reported outcome measures.