OHE at ISPOR Europe 2: Conceptual and Practical Challenges in Judging Value

ISPOR’s 17th Annual European Congress is scheduled for 8-12 November 2014 in Amsterdam. This is the second of two blog posts that outlines OHE’s involvement. (The first blog is available here). Please feel free to contact any of the OHE team members listed for additional information.

Innovation and value

Conceptual challenges: valuing cures

1.       What Value Do We Place on a Cure? Value Demonstration Challenges Associated with Innovator and Regenerative Therapies in the EU, North America, and Asia.

Moderator: Eric C Faulkner (University of North Carolina, Chapel Hill) Panelists: Adrian Towse (OHE), Don Husereau, University of Ottawa and UMIT, Joshua J. Carlson (VeriTech Corporation) (IP6, 11 Nov, 10:15–11:15)

This panel addresses the implications of assessing the cost-effectiveness of emerging regenerative medicines, including gene therapy “cures”, looking at how payment could be financed and linked to outcomes.

Practical challenges: pricing/reimbursement and innovation

2.       An Introduction to Multi-criteria Decision Analysis in Health Care Decision Making – Emerging Good Practices.

Chair: Maarten J IJzerman, University of Twente and MIRA Institute for Biomedical Technology & Technical Medicine.; Speakers: Nancy Devlin (OHE), Praveen Thokala (University of Sheffield) and Kevin Marsh (Evida). (ISPOR Forums Session I, 10 Nov, 18:00-19:00)

This forum will highlight the work being done by the ISPOR Taskforce on emerging good practices in MCDA, which Nancy co-chairs. The objective of the taskforce is to provide a common definition for MCDA in health care decision-making and to develop good practices for conducting MCDA to aid health care decision making. 

For OHE’s primer on MCDA, click here. 

3.       The Expanding Value Footprint of Oncology Treatments.

Juan Carlos Rejon-Parrilla (OHE), Karla Herandez-Villafuerte (OHE), Koonal K Shah (OHE), Jorge Mestre-Ferrandiz (OHE, presenting), Lou Garrison (University of Washington) and Adrian Towse (OHE)

This poster examines the history and importance of HTA evaluations for additional uses for cancer drugs after their initial approval. The cohort of cancer drugs included are the ten approved by the EMA during 2003–2005. The decisions of three entities are included in the study: the Haute Autorité de Santé in France; NICE in England and Wales; and Aetna, a private health insurance company in the US. These three were selected to suggest how assessment approaches might differ in interpreting value. (PCN227, 12 Nov, 08:45–14:45)

For a recent version of the study, click here.

Dealing with uncertainty while enhancing access

4.       Earlier Access to Innovation – Is It worth It?

Moderator: Adrian Towse (OHE), with.Hans-Georg Eichler (EMA), Richard Bergstrom (EFPIA), Carole Longson (NICE), and Alric Reuther (IQWiG).

This plenary will explore whether earlier licensing of products will benefit patients, given the challenges faced by HTA bodies in making assessments with limited evidence. It will address adaptive licensing, coverage with evidence development, and other programs to deal with evidence uncertainty. (Second Plenary, 11 Nov, 13:30–15:00)

5.       Performance-based Risk-sharing Arrangements for Drugs and Other Medical Products.

Adrian Towse (OHE), Lou Garrison (University of Washington) Josh Carlson (University of Washington)

This short course explores the theory and practice behind PBRSAs, including trends, and the challenges involved in putting them in place. Prior registration is required. 8 Nov, 14:00–18:00

Comparative cost effectiveness analysis for a specific condition

6.       A Cost-effectiveness Analysis of Interventions for Symptomatic Varicose Veins.

Grace Marsden (OHE, presenting), Mark Perry (National Clinical Guideline Centre), Andres Bradbury (University of Birmingham), Nicholas Hickey (University of Birmingham), Kate Kelley (National Clinical Guideline Centre), Hazel Trender (Sheffield Teaching Hospital Foundation Trust), David Wonderling  (National Clinical Guideline Centre) and Alun Davies (Imperial College & Imperial College NHS Trust)

This poster reports on an economic analysis that formed part of the NICE clinical guideline on varicose vein treatment and was conducted to investigate whether such treatments should be recommended across the UK. It compared the cost-effectiveness of surgery, endodermal ablation, ultrasound guided foam sclerotherapy and compression stockings using a Markov decision model with a five-year time horizon. (PCV94, 11 Nov, 8:45–13:30)

Health care systems: methods for valuing health states

Methods: instrument design

7.       Valuing EQ-5D-5L: Does the Ordering of the Health Dimensions Impact on Health State Valuations?

Brendan Mulhern (University of Sheffield, presenting) and Koonal K Shah (OHE)

This presentation is based on research intended to explore whether changing the order in which the five health dimensions are presented affects the outcome of the exercise. The analysis is based on face-to-face, computer-assisted interviews with 450 members of the general public. (PR4, 10 Nov, 15:30–16:30)

Methods: eliciting more accurate TTO results

8.       What Is the Appropriate Comparator Health State to Use in Time Trade-off Studies?

Koonal K Shah (OHE, presenting) and Brendan Mulhern (University of Sheffield)

This poster reports findings from a methodological health state valuation study. Studies to produce utility values for the EQ-5D-5L instrument include the valuation of 10 health states using the time trade-off (TTO) method. In some of the studies, relatively low mean TTO values for mild health states have been observed. One hypothesis is that this is because the health states under evaluation are being compared to ‘full health’, whereas in previous studies they were compared to 11111 (the ‘best’ health state in the descriptive system). This poster assesses differences in TTO valuations using these two comparators. It is based on 450 interviews that were completed in mid-2014. (PRM162, 11 Nov, 15:30–19:30)