OHE at AES 2016: Early Access Schemes, Equity Adjusted QALYs, Multi-indication Pricing and Formulary Development

The Spanish Health Economics Association (AES) Conference was held at the University of Murcia, 15-18th June 2016. The topic of the meeting was “Reforms under the microscope”. Several members of the OHE team attended and contributed to the conference; this post summarises their activity.

The 36th Spanish Health Economics Association (AES) Conference was held at the University of Murcia, 15-18th June 2016. The topic of the meeting was “Reforms under the microscope”.

Several members of the OHE team attended and contributed to the conference. This post contains a summary of their activity.

Multi-Indication Pricing: Pros, Cons and Applicability to the UK by Jorge Mestre-Ferrandiz

Multi-indication pricing (MIP) involves setting a different price for each indication approved for a medicine. The objective of this work was to outline the pros and cons of MIP, and its potential applicability in the UK. The analysis was partly based on a workshop with stakeholders, including HTA agencies, pharmacists, economists and clinicians.

Equity Adjusted QALYs? QALYs and Equity by Adrian Towse

Adrian Towse presented on Equity Adjusted QALYs? QALYs and Equity. In this presentation he:

• Looked at definitions of equity, drawing on work by Tony Culyer;
• Gave his view of lessons from the England value-based pricing (VBP) saga in which practical ways of implementing severity and societal impact adjustments to QALYs were identified but rejected;
• Concluded that moving from listing the things that matter to measuring them to weighting them are three very different steps. Weighting in any form makes the Social Welfare Function explicit and will inevitably generate a backlash. A fair process is therefore required which combines elements of societal weighting which are quantified with a structured deliberative decision making process.

The presentation also looked at the Capability Approach; “What should be in the Value Framework?” and the use of Extended CEA to take account of income inequality in Middle and Low Income Countries.

Modelling the Value of Early Access Schemes and Adaptive Pathway Approaches by Mikel Burdud

A range of early access agreements and adaptive pathways have been implemented in the last 15 years to expedite the development/licensing of promising new medicines. The aims of such policies are to provide timely access to medicines for patients with high unmet medical need and to incentivise innovation and R&D.

Berdud and colleagues model existing early access and adaptive pathway policies for a real case study. They assess the impact of the policies from the perspective of a range of stakeholders.

The conference slides are not available, but a full report of the study is forthcoming.

Options for Formulary Development in Middle-Income Countries by Karla Hernandez-Villafuerte

A number of middle-income countries (MICs) are evolving their health systems toward universal health coverage for patient populations. Such countries often have limited drug formularies and some form of essential drugs list. This presentation explores options for bridging the organisation of the health system and its priorities, and provides a framework for developing drug formularies.