Rising health care costs, including prescription drugs costs, are a growing concern for governments, employers, and individuals. These increases were making health care value analysis essential before the COVID-19 pandemic and pressure will increase as financial and fiscal anxieties mount.
To ensure continued investments in innovative treatments that save lives and improve outcomes, any value assessment needs to examine a treatment’s wholistic effect on the health care system and individuals. Current Health Technology Assessments (HTAs) inadequately evaluate factors outside of clinical evidence and health care costs. Current HTAs across the world result in:
- Bureaucratic Delays
- Limited Access to New Treatments
- Politicization of Review Process
- Evaluation Based on Limited Clinical Evidence
- One Size Fits All Approach
- Fragmented Economic Impact Analysis
Despite current HTAs’ limitations, pressure is growing on policymakers, payers, and drug manufacturers to evaluate the value derived from new treatments. As more innovate treatments come to market, pressure will grow. These data points underscore the need to develop a wholistic approach to redefining value:
- 25% – Percentage of adults reporting difficulty affording prescription drugs in 2019 (2019 Janssen Transparency Report)
- $2.6 Billion – Average R&D cost for approved prescription drug – a 145% increase from 2003(Tufts Center for the Study of Drug Development)
- 38% – Percentage of pharmaceutical executives believing potential rewards of value-based contracting worth the risks (PwC’s Health Research Institute)
An opportunity exists for drug manufacturers to create an effective, innovative method to evaluate value. To be truly effective, these assessments should examine a range of variables including social determinants of health, health care system benefits and costs, effectiveness for patients, and pricing risk. A multi-variable assessment would establish a credible, innovative approach to value definition. By establishing this new tool, pharmaceutical companies can build stakeholder support, marketplace credibility, and buy in from policymakers and regulators. Drug manufacturers must own the value assessment evolution or risk the consequences of bureaucratic overreach.
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