Exploring Variations in the Opportunity Cost Cost-effectiveness Threshold by Clinical Area: Results from a Feasibility Study in England
OHE, in collaboration with RAND Europe and King’s College, has been awarded a research grant from Cancer Research UK exploring outcome-based payments.
OHE, in collaboration with RAND Europe and King’s College London, has been awarded a research grant from Cancer Research UK in partnership with Greater Manchester Health & Social Care Partnership (GMHSCP). The aim of the research is to explore the evidence base for an outcome-based payments system for cancer drugs.
Can we create a model of paying for new cancer drugs on the basis of the outcomes they achieve? This question was raised by Cancer Research UK, in a Research Brief (PDF), as a potential way of addressing the challenges faced by health care in England, including the NHS’s unprecedented financial challenges, current advances in the development of new precision treatments for cancer, NICE recommendations being increasingly based on immature data, increasing use of real-world evidence in clinical settings, and the right of cancer patients to have quicker access to innovative evidence-based cancer drugs.
The Office of Health Economics, RAND Europe, and King’s College London have been awarded a research grant from Cancer Research UK in partnership with Greater Manchester Health & Social Care Partnership. The research team will assist Cancer Research UK in taking the first steps to meeting the challenge, which will involve undertaking a comprehensive review of the literature to find out what outcomes are currently being measured in real-world settings globally, including where outcomes-based payments systems are already in place. This phase will be complemented by qualitative research with patients, clinicians, and commissioners, as well as other key stakeholders with the aim of identifying measurable outcomes that can reflect the value of new drugs through the use of real-world evidence.
The joint research team has a wealth of experience in the study of cancer outcomes and their potential linkage to payment arrangements.
OHE’s team includes:
- Paula Lorgelly, who has expertise in the economics of cancer (e.g. survivorship, precision medicine and reimbursement) and cancer patient-reported outcomes (e.g using quality-adjusted life years, comparing generic versus condition-specific measures and discrete choice experiments)
- Patricia Cubi-Mollá, experienced in the analysis of adaptation to chronic illnesses, outcome measures and patient experience; and
- Amanda Cole, who has led or contributed to projects relating to improving efficiency and resource allocation in cancer care, expediting access to new medicines through adaptive pathways, analysing data governance requirements for real-world data, and using real-world evidence to facilitate managed entry agreements.
- Adrian Towse and Nancy Devlin will apply their expertise on value-based pricing/reimbursement and patient-reported outcomes by advising the research team throughout the project’s development. The members of the OHE team are also undertaking related research on cancer patient-reported outcomes, as detailed in our blog.
RAND Europe’s team is led by their Chief Economist Jon Sussex, whose work has included value-based reimbursement of medicines and the national evaluation of Payment by Results in the NHS; Miaoqing Yang and Jack Pollard, who are health economists with research experience in health care policy evaluation using both quantitative and qualitative methods. Sonja Marjanovic will provide expert advice on understanding the interface between health research and innovation.
Prof Richard Sullivan, from the Institute of Cancer Studies, King’s College London, will act as an expert adviser offering insights on clinical cancer outcomes and cancer care.
This research will support a better understanding of what is of ‘value’ in the treatment of cancer patients that can be measured in practice, and will generate an evidence base which can inform decision-makers such GMHSCP, the Department of Health, NHS England and NICE. Depending on the results of the study we can provide recommendations on whether to consider outcome-based payments as a flexible pricing mechanism that could be adopted across the NHS in England.
For more information please contact Patricia Cubi-Molla.
