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Understanding the Full Value of Long-Acting Therapies: less is more?

Compared to shorter acting therapies, long-acting therapies might be overlooked and hold potential for patients, healthcare systems and society:
Realising the potential value of long-acting therapies is currently hindered by a narrow view of value in health technology assessment (HTA) and variability across HTA agencies. HTA value frameworks risk under-recognising the broader value of LA therapies. The potential for benefits in key areas such as patient choice, productivity gains, and environmental impact are often overlooked. Countries with more flexible HTA frameworks, like Canada and the UK, are better positioned to capture these broader value elements than others like Germany and France.
Stakeholder collaboration can help to achieve the necessary policy changes. To account for broader potential of LA therapies, HTA frameworks need to adapt by incorporating broader value elements and leveraging real-world evidence. This will incentivise innovation, ensure equitable patient access, and support sustainable investments in transformative treatments for chronic disease management.
These therapies are particularly effective for chronic conditions, which require long-term treatment. In this report, we primarily focus on injectable therapies that have durations of action and administration frequencies of up to six months, acknowledging for some therapies it can be even more.
This report aims to identify the potential value of LA therapies for patients, physicians, healthcare systems, society, and the economy. Furthermore, it investigates whether the potential value of LA therapies is considered in HTA and payer decision-making. We conducted a targeted literature review and analysed four LA therapy product case studies in HTA decision making.
The full value of LA therapies
This report shows that LA therapies have the potential to offer a variety of benefits for patients, health systems, and society more broadly.
Patient-level effects:
Healthcare system impact:
Societal and economic impact:
HTA considerations
Results from product case studies demonstrate that in certain therapy areas, despite the potential wide-ranging impact, the broader value of LA therapies is currently under-recognised in health technology assessment (HTA) and reimbursement decisions. Analysis across ten global HTA bodies reveals significant variability in the extent to which and how elements of broader value relevant to LA therapies are considered. While clinical effectiveness, patient quality of life, and healthcare cost reductions are commonly assessed, elements like productivity, patient choice, equity, and environmental effects are often overlooked. Notably, countries that use broader, more flexible value frameworks as part of their HTA and those that are open to considering real-world evidence, like Canada and the UK, incorporate these broader elements more frequently than markets focused strictly on additional clinical benefit, such as Germany and France.
Conclusion
Compared to shorter acting therapies, LA therapies hold great potential to transform chronic disease management, delivering value across multiple dimensions. Realising LA therapies’ full potential requires adapting HTA frameworks to reflect their comprehensive benefits, enabling equitable access for patients and incentivising further innovation. This strategic approach will ensure optimal healthcare outcomes in the short term and allow for sustainable ongoing investment in these treatments in the future.
Recommendations
Stakeholders should collaborate and involve patients and their healthcare professionals to ensure that the development and implementation of LA therapies align with patient needs, health system improvements, and societal or economic goals.
This report, Understanding the Full Value of Long-Acting Therapies: less is more?, was commissioned and funded by GSK.
Understanding the Full Value of Long-Acting Therapies: less is more?