The proposals from the UK Department of Health (DH) for value based pricing (VBP) include a process whereby higher prices would be granted to medicines that tackle the most burdensome diseases – i.e. those that are most severe or are associated with the greatest unmet need. The DH’s VBP consultation document defines unmet need in terms of the degree to which alternative treatments exist. Little empirical evidence is available, however, on whether the general public supports the use of this particular definition of unmet need as a basis for setting health care priorities. To address this gap in the evidence, Koonal Shah and Nancy Devlin of OHE completed a small exploratory study.

The proposals from the UK Department of Health (DH) for value based pricing (VBP) include a process whereby higher prices would be granted to medicines that tackle the most burdensome diseases – i.e. those that are most severe or are associated with the greatest unmet need. The DH’s VBP consultation document defines unmet need in terms of the degree to which alternative treatments exist. Little empirical evidence is available, however, on whether the general public supports the use of this particular definition of unmet need as a basis for setting health care priorities.

To address this gap in the evidence, Koonal Shah and Nancy Devlin of OHE completed a small exploratory study, reported in the most recent OHE Research Paper. The aim was to design and test an approach to eliciting public preferences about setting priorities for health care based on unmet need and disease severity. In face-to-face interviews, 60 respondents each answered 11 questions about setting health care priorities, many of which involved choosing between achieving large health gains, treating the severely ill, and addressing areas of unmet need.

The key findings of the study are:

• Maximising health gain was considered by most of the respondents to be more important than the competing objectives of giving priority to (1) the severely ill or (2) conditions for which no alternative treatment exists.

• The level of support for an implied policy of giving priority according to unmet need varied greatly from question to question. Responses appeared to be influenced heavily by how the questions were framed.

Download Shah, K. and Devlin, N. (2012) Understanding social preferences regarding the prioritisation of treatments addressing unmet need and severity. Research Paper 12/05. London: Office of Health Economics.

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