Payer demand for value indicators that can guide reimbursement decisions are prompting leading pharmaceutical companies increasingly to seek input into clinical development from their health economics teams, a new study has found.
While clinical data are instrumental in driving reimbursement decisions, companies that analyse only completed trial data to determine a product’s economic benefit “typically face difficult questions from payers”, notes Cutting Edge Information.
At 15% of top 20 pharmaceutical companies surveyed for the study, Health Economics and Outcomes Research: Aligning Clinical and Commercial to Meet Payer Demands and Win Reimbursement, health economics experts now work closely with their colleagues running clinical trials, Cutting Edge Information found.
Health Economics and Outcomes Research (HEOR) teams are the best resource for determining outcomes of interest to payers, it says. Clinical development colleagues may already be looking for input once a drug is in Phase III development.
“Testing a product against a placebo may lead to regulatory approval in some cases, but it is unlikely to be sufficient for reimbursement,” comments Michelle Vitko, senior research analyst at Cutting Edge Information.
“Payers want to see that a product effectively treats a disease and that the average patient’s product use will lead to a better outcome than [with] other products,” Vitko adds.
“Ideal outcomes lead to fewer doctor visits, a shorter hospital stay or lower rates of complication, all of which are expensive for payers.”
Clinical development teams are more likely to leverage the HEOR team’s input when trials are designed with the US or major European markets in mind, the study revealed.