HEALTH ECONOMICS BLOG - Trends, Politics, Opinions etc. in biotech & pharma industry

Southern EU states present unified front in drug talks

noreply@blogger.com (Unknown) — Thu, 18 May 2017 12:04:00 +0000

Folks an article on the intensified pricing collaboration activities among European countries. This has been a long debate for years but it seems more concrete steps are undertaken. Its a pity that countries still don't realize that engaging with the industry on different and novel payment models is more promising than the ever increasing eagerness on pure cost mindset "collaboration". Affordability is an important criterium and can be adressed differently, all these joint purchasing efforts however will only create more inefficiencies and bureaucracy and most likely increase time to access for patients, especially those with rare diseases. It ignores the fundamental economic principle of price differntiation in accordance withbthe exonomic situation and circumstances in every country. Lets hope they can prove me wrong on this one.

The Future of Health Economics - new book availabe soon

noreply@blogger.com (Unknown) — Tue, 04 Oct 2016 17:18:00 +0000

Dear All,

Olivier, the "work horse" ;) finally managed to get all the chapters back from the various authors and the book goes into print. Book should be available at Routledge in a couple of month.

Regards
Ulf

IQWIG not bullish on EMAs adaptive pathways pilot

noreply@blogger.com (Unknown) — Thu, 18 Aug 2016 09:38:00 +0000

Hi All,

just saw an interesting post (https://www.iqwig.de/en/press/press-releases/press-releases/adaptive-pathways-ema-still-leaves-open-questions-unanswered.7492.html) from IQWIG, that speaks to the difficulties to get even a clinical effectiveness assessment under one roof as always proposed by various stakeholders. Clearly the RWE bit is still an open book in many ways but a topic to be tackled on various fronts in order to make true value based pricing a reality.

Cheers
Ulf

Drug prices: Tweaking the formula

noreply@blogger.com (Unknown) — Wed, 27 Apr 2016 12:52:00 +0000

Financial Times

By Andrew Ward

April 25, 2016

What is the value of a human life? It is one of the most fraught questions in public policy as governments around the world struggle with rising healthcare costs from ageing populations.

The answer matters not only to patients, taxpayers and insurers, but also to the pharmaceuticals companies seeking rewards for the medical advances that have helped double global life expectancy in the past century.

Nowhere is the debate more intense than in the UK, where budget pressure on the National Health Service has capped growth of the annual £12bn drugs bill and created tensions with the often competing interests of the pharma sector.

“We can’t continue as we have in the past,” George Freeman, UK life sciences minister, told a conference in London last week, urging a “new deal” between government and drugmakers.

Mr Freeman’s vision will be set out in an official report later this year which is expected to propose mechanisms for getting the most promising new therapies to patients faster and affordably. Meanwhile, an overhaul of the way cancer drugs are evaluated for the NHS is due to come in to force in July.

Together, these developments promise to make the UK a test of whether austerity-hit western societies can keep up with the quickening pace of medical innovation. A surge in drug approvals over the past two years has revived faith in the pharma industry’s productivity after a long fallow spell and a further wave of products are nearing market, many involving transformativetechniques targeting faulty genes or modifying cells. Yet the cost of these advances threatens to increase strain on the NHS as it chases savings of £22bn by 2020.

It is a dilemma echoed in public health systems across Europe but also, increasingly, across the Atlantic as the US seeks to keep a lid on the $3tn it spends each year on healthcare.

At the forefront of pharma

The UK’s importance as a test bed goes beyond its 3 per cent share of global pharma sales. As home of GlaxoSmithKline and AstraZeneca, two of Europe’s largest drugmakers, and half the world’s top 10 medical research universities, according to Times Higher Education, the country punches above its weight in life sciences. Many of the world’s best-selling drugs belong to a category called monoclonal antibodies pioneered by UK scientists in the 1970s and 1980s.

Yet British patients have not always benefited from homegrown innovation; the country has among the slowest uptake of new drugs in western Europe. This reflects the tough hurdles created by the National Institute for Health and Care Excellence, which acts as gatekeeper for companies seeking access to the NHS for their medicines. The agency, known as Nice, weighs the price of a treatment versus the benefit to patients measured by a formula called “quality-adjusted life years added” or qualy. It will not normally recommend a drug costing more than £30,000 per qualy.

This dispassionate approach to life and death decisions has given Nice global influence as a model of evidence-based policymaking. Yet the UK system has many critics, especially among drug companies and patient groups who see its methodology as too rigid and its £30,000 spending cap as too low. “Only a very small number of countries operate with such a fixed threshold,” says Richard Erwin, UK general manager for Roche, the Swiss pharma group.

The fiercest disputes have involved cancer drugs. These tend to be very expensive — especially those for advanced or rare forms of the disease — because companies need to make a return on investment from relatively small numbers of patients during short periods of treatment. In recognition of these issues Nice has a higher £50,000-per-qualy threshold for “end of life” treatments. Even this is often not high enough for modern cancer drugs. Since 2011, the agency has rejected more than half the treatments it has evaluated.

Funding pressure

For admirers of the UK system, Nice should be applauded for its scepticism towards drugs that often provide just a few extra months of life, at best, for large sums of money that could be used more productively elsewhere in the NHS. “The price we can afford to pay is the point at which the benefits [of a drug] match the benefits we are going to give up as a consequence of those net costs,” says Karl Claxton, a health economist at the University of York.

This argument might seem incontestableto academics but David Cameron, UK prime minister, knew that cancer patients and their families would not accept it. Alarmed by data showing the UK falling behind other western European countries in cancer survival rates, he set up a special scheme in 2010 to provide extra funds for cancer drugs deemed too expensive by Nice.

Since then, 80,000 people have received treatments through the Cancer Drugs Fund. Without Nice’s scrutiny, there was no pressure on companies to moderate prices or doctors to moderate use. This resulted in the cost of the fund soaring from £38m in 2010-11 to £416m in 2014-15 — 50 per cent over that year’s budget. “The Cancer Drugs Fund shows once and for all that there is no blank cheque big enough to solve this problem,” says Prof Claxton.

In an attempt to restore fiscal discipline, NHS England in February confirmed plans to restore Nice’s power of veto. From July, it will evaluate all new cancer drugs within 90 days of regulatory approval — faster than in the past — and issue a “yes, no, or maybe”. The “maybes” — medicines that show promise but require more evidence — will be financed for up to two years by a revamped Cancer Drugs Fund. Only if they prove their worth during that probation period will they be recommended for use.

NHS England say the changes will put cancer care back on a sustainable footing and ensure money is directed at the most effective treatments. However, there have been protests from pharma companies and their allies which fear that without change to Nice’s methodology, most of their products will be blocked. One charity said cancer care in the NHS risked being “set back by a generation”. Erik Nordkamp, UK managing director for Pfizer, said even crisis-hit Greece had wider access to the latest treatments.

Sir Andrew Dillon, Nice chief executive, says there is a simple remedy: companies should drop their prices. “Unless there is a change in price or in the quantum of benefits these drugs bring to patients, then the Nice methodology will result in broadly the same outcomes as before. Ultimately, it is up to the companies to decide.”

Drugmakers question why they should be expected to offer further discounts to the UK when it already has among the lowest prices in the developed world. The industry has paid more than £1bn in rebates to the Department of Health since a 2013 deal that capped annual growth in the NHS drugs bill at a below-inflation rate for five years — with companies collectively reimbursing any spending above the agreed limit.

The fear is that any further squeeze in the UK would have a knock-on effect on pricing across Europe. This, in turn, would risk increasing US political scrutiny of the transatlantic divide in drug costs that can see Americans pay double the price for medicines — due in large part to the absence of UK-style controls on spending.

There is little immediate prospect of the US setting up a federal rationing body. However, there are signs that some people are learning lessons from Nice. New York’s Memorial Sloan Kettering Cancer Center, one of the leading US cancer hospitals, last year launched an online tool called DrugAbacus to help healthcare providers assess the value of cancer drugs.

Drug companies are responding by experimenting with pay-for-performance models tied to how well a medicine works rather than the volume sold. But Alexander Moscho, UK head of Bayer, the German drugmaker, says the qualy system is not flexible enough for the new world of personalised medicines. “It needs a new approach which is not one-size-fits-all.”

Sir Andrew, who has been in charge of Nice since its launch in 1999, denies that the system is broken. “I would not argue that Nice’s methodology is perfect but I don’t think there is anything fundamentally wrong with it either. In terms of being able to do a rigorous evaluation of what a product offers, I think we do that really well.”

Drug makers have been at loggerheads with Nice since its first ruling 17 years ago prompted a veiled threat by Glaxo to quit the UK, saying the decision called “into question the suitability of the UK as a base for multinational pharmaceuticals operations”. AstraZeneca, which is building a £330m R&D base in Cambridge, issued a similar rebuke last year when Nice resisted olaparib, its homegrown ovarian cancer drug. “How can a government say they want this country to be an innovation centre … yet when we discover new innovation it doesn’t find a market?” asked Pascal Soriot, chief executive.

For advocates of Nice, these confrontations are proof that the model has succeeded in creating a neutral arbiter. Pharma leaders, however, feel there should be more support for an industry that accounts for a quarter of the UK’s private sector research and development spending.

“If new medicines are not being used in the UK, global companies will not invest here,” says Mike Thompson, chief executive of the Association of the British Pharmaceutical Industry.

Open access

It is this stand-off that led Mr Freeman to launch the accelerated access review last year, led by Sir Hugh Taylor, formerly a senior civil servant at the health department. His report has been delayed, like much else in Whitehall, until after the referendum on UK membership of the EU in June.

It is expected to propose that new medicines showing the greatest promise should be given early conditional access to NHS patients. Usage would be gradually expanded as “real world” data are accumulated on safety and efficacy. In theory, this should lower drug development costs by reducing time to market and lead to more consensual pricing discussions based on a clearer picture of the value offered.

“Everyone benefits: companies get a quicker return on a lower investment and patients get access to medicines faster,” says Stuart Dollow, an adviser to Sir Hugh’s review. “It is about getting away from the current adversarial model where industry goes in with a high price knowing it is going to get negotiated down.”

Pharma companies say they can be part of the solution to the NHS budget crisis by providing treatments that reduce long-term costs. Novartis, the Swiss drugmaker, last week reported strong demand in Europe for a new drug that has shown the potential to cut hospitalisation rates from heart failure by a fifth.

“We need to stop looking at medicines as a cost and look at the value they can create for UK plc,” says Mr Thompson. He admits, though, that the industry will have to be realistic about pricing. “There is a clear message from government: There is no more money.”

Patient Access positions with Baxalta

noreply@blogger.com (Unknown) — Sun, 22 Nov 2015 13:34:00 +0000

Dear Readers,

I am currently building my access team in EMEA and have a few positions open. I am looking for a patient access lead oncology Switzerland/Austria. See job posting: https://lnkd.in/d3MyQgQ

Equally I am looking for patient access heads for Italy and the UK. Oncology experience plus experience with local P&R submissions and negotiations is required.

If you are interested please get in touch: ulf.staginnus@baxalta.com

Cheers
Ulf

England NHS cancer drug fund to be handed over to NICE?

noreply@blogger.com (Unknown) — Thu, 23 Jul 2015 16:32:00 +0000

Dear All,

Some interesting developments on the Cancer Drug Fund have been announced today.

Cheers
Ulf

Market Access in Germany and AMNOG reform needs

noreply@blogger.com (Unknown) — Thu, 18 Jun 2015 10:08:00 +0000

Dear All,

hope you are getting ready for the summer.. just came across an interesting post on the GKV Spitzenverband website. A latest study from the Technical University of Berlin demonstrates the fastest (even after AMNOG) and broadest access to medicines occurs in Germany as compared to other EU countries (well, it´s nothing really new). This comes at a "cost" with highest pharmaceutical prices being paid in Germany (we also knew that). The study has a lot of good sources such as the times to access after EMA approval (many of you in the industry get this question all the time from management), approaches to pricing in the different EU countries as well as the reference baskets etc...

The interesting part comes further down in the GKV press release. Prof Busse (check out his slides) suggests that pricing is related to the benefit provided in each subgroup. Something economists welcome as it it would allow for differential and indication specific pricing better linking value achieved to pricing potential. The pessimists would obviously say that it further increases pressure but in my view that would be the right direction and for really innovative and beak through therapies provides opportunity.

Reform needs are seen with AMNOG, measures such as retrospective rebates are suggested in the presentation from v. Stackelberg (GKV SV) from month 7 onwards of the benefit assessment process. He makes a fair statement in saying with "retrospective price setting premium pricing is still possible for top products, but no excessive pricing for drugs without additional benefit".

Let's see what is cooking out in Germany. Happy Summer Holidays ;)
Cheers
Ulf

The value discussion

noreply@blogger.com (Unknown) — Sat, 21 Mar 2015 10:40:00 +0000

Dear All,

first of all apologies for the quite time lately, been busy with various projects. Seeing the article from Ed it reminded me of the ever ongoing discussion about the value topic and if agreement can be found between payers and industry. Certain attempts, thinking here of VBP in the UK have failed and others have not taken off. Ed does a good job in listing the issues and especially pointing out the ways the industry could change things internally. This is definitely true and also a very old story. I have a bit of my own theory why things are so slow to catch on internally. Everyone is talking the market access talk and adds resources and re-invents departments etc. What I see happening though is that the wrong people with the wrong skill set are often doing this. Just because it seems to be hip to talk about payers and access and engagement doesn't necessarily mean the skills are there. Too many of certain "talkers" who are used to making colorful slides are digging around the access area, which however doesn't make them an expert just as yet. Health economics and especially pricing and skills around data creation and epidemiology are typically missing. Also lack of experience with the various health care and reimbursement systems and how things are working often leads to the wrong expectations. I couldn't agree more with Ed's comments that functional organizations, usually the experts from health economics/pricing and access, get the issues quickly but often have limited influence to the top and on R&D decision making as there still too often the old fashioned "slide makers" and "talkers" are sitting. The 'species' of real good access people often doesn't bother to engage on this "less scientific" level of discussions hence nothing ever changes. The only way to change that would be if jobs are re-defined and key roles are being filled with people who have exactly that payer perspective and experience - and they don't need to have been in sales to do a fine job there. That is a relict from a time that doesn't exist and wont come back anymore.

Cheers
Ulf

Potential "Pay if you clear" access scheme in Scotland

noreply@blogger.com (Unknown) — Tue, 14 Oct 2014 13:19:00 +0000

Dear All,

just saw this on BBC

Now if that scheme materializes it truly deserves to be called an innovative one ..

Cheers
Ulf

Jobs and interviewing in Market Access, Health Economics and Pricing

noreply@blogger.com (Unknown) — Thu, 24 Jul 2014 10:16:00 +0000

Dear All,

a little post from the beach, I trust most of the readers enjoying their well deserved summer vacation. By popular demand in the past when I conducted and published my salary review, and actually due to a lot of personal experience, I am finally getting around on writing a little about the topic of interviews and job search. Most positions in our field are recruited by headhunters or company talent scouts but also network and other ads, e.g. on pages like healtheconomics.com and healtheconomics.org are important information for job seekers. Networking through linkedin.com has also proven very valuable for many of my colleagues and fiends. But nothing beats a personal recommendation or contact that puts you in touch with a potential employer. Therefore in identifying positions you should not find it too difficult as this market is rather transparent and demand for health economists, market access and pricing as well as health policy people seems to be still steadily increasing.

What is interesting is how different companies conduct their interviews. I must say I came across the whole spectrum from very professionally conducted and fast processes to total odd behavior. One day for example I went to an interview for a position of EU market access head with a specialty pharma company and flew about 8 hours in one day taking 4 flights, and changed an important family event travel in order to get to a city in Eastern Europe where they were at a conference. Finding the meeting room the head of Europe of this firm shows up, and with very little introduction and barely a 'hello' and combined with a rather odd and impatient behavior asked me about an old story that he had encountered years back in one EU country where a drug was supposed to be introduced into the market and they had some package insert issue of a cardiovascular agent that the agency apparently had been misplaced etc. etc... now wanting to know what I would have done... I was a bit puzzled about the wired case and answered that this was a regulatory matter usually not in my shop but as in any interaction with authorities would have gone back to them with another copy of the package insert and asking them politely to reconsider and approving bla bla bla.. that was apparently not a very satisfying answer and even more impatient now the guy rambled on about how this would have delayed his launch in the country as the agency would have found another excuses and bla bla bla.. now me getting tired I simply said (so smartass I thought to myself) what did you finally do? ..well he said he put the updated package insert and launched without approval of the regulatory agency and than creating some political pressure and bla bla bla.. as you can guess by now we are talking about a Southern European country here with lovely pasta tough... anyhow, I just responded dry, coming from a couple of companies that take compliance as a serious value, that is an answer he couldn't have expected to receive from me... anyway the talk didn't get better, we went through a few more odd cases alike and the second guy that showed up thereafter, equally arrogant, didn't really improve my day.

A few days later they (I had advanced already another process with a biotech that professionally quick conducted two interviews in one day, plus a few on Skype the day thereafter) wasted more time by having had the headhunter call one of my references etc.. just to tell me two weeks later, via the recruiter, they were still deliberating and thinking and needed to ask more references about my strategic abilities... probably due to my answers on the package insert discussion beforehand ;)

That's when I decided I had enough of this BS and emailed the headhunter to call it a day with this process, which I should have probably done right after the second round 8 hour trip... after all in my career I had launched more than 4 major products in Europe each of them largely exceeding their one or two product portfolio and therefore concluded to myself that I had no desire no need for additional nonsense from this company. I was wondering anyway what they really wanted here.. it seemed like they were selling a glorified "head" as sort of an assistant to the two guys probably wanting to get rid of stuff they didn't wanted to do anymore... outside voices later on confirmed my sensation about a wired climate there...

But why am I telling you all this, what's the morale of the story here. Well, know your worth and live it! Don't sell yourself too cheap or too fast nor let yourself in strange situation be diverted from what your true experience but moreover your values are. Don't settle for any compromise that doesn't feel right even if you may get impatient with your job search. And remembering Steve job's famous words from a Stanford graduation, don't let your inner voice be drowned by other peoples opinion, don't settle if it doesn't feel right, keep looking, stay hungry, stay foolish ;) !!! and listen to your gut feeling...

And here my personal checklist:

- do your background research very well, ask around, this is a small world, you quickly would find out why a role is vacant too often or takes too long too fill.. there might be personality issues at this company
- ask about the real responsibilities, who decides what, what can you do, are you going to be part of negotiations/authority contacts etc? Who decides your travel, can you attend certain professional meetings/conferences? What budget does the role have, reporting lines etc as titles often are inflated or mean little. From a certain level onwards you don't want to sit around in the headquarter talking about the payer needs but actually never seeing the payer
- be wary of two many rounds and hick hack, the best jobs and match in my experience are those where the process is closed from first call to signature in 4-6 weeks max. Imagine if the process is a major pain, what will the work environment be like ???
- don't become a quotation filler, in other words feel when you are being put forward just to fill the candidate pipeline, don't waste your time with silly presentations unless you need interview practice
- be open and transparent about your situation, financials and expectations but also request the same
- people who don't hold their word... will call you back by Friday, and don't.. drop them, no worth considering, they will continue like this
- you get an offer with the one you like, they have been quick, honest, with professional style and ethics - take it quickly and don't be too fussy about unimportant things, negotiate the big items important to you, if the salary is great and you get stock .. don't patronize about canteen vouchers for example ;) .. you are laughing, I have seen it...
- and I repeat it, trust your gut, if something doesn't feel right it will be most likely not be good in the end
- remember for skilled people with experience this is a buyers market, far more demand than qualified people, get the right job for you and wait if the first one that comes along casts any doubts

Cheers to all readers, happy summer holidays!
Ulf

Guidelines for payment by results in Catalunya

noreply@blogger.com (Unknown) — Mon, 26 May 2014 13:57:00 +0000

Dear All,

CatSalut has published a first version of guidelines for the implementation of payment by results schemes for pharmaceuticals.

http://www20.gencat.cat/docs/salut/Minisite/catsalut/Proveidors_professionals/medicaments_farmacia/Acords_Risc_Compartit/Guia_EPR_castellano_1.0.pdf

Regards
Ulf

No linear association between drug prices and perceived benefit criticises US cancer expert...

noreply@blogger.com (Unknown) — Thu, 08 May 2014 14:11:00 +0000

Dear all,

pricing of cancer drugs and now also hepatitis C has steered another debate among US payers and physicians about drug prices. See a recent article in business week.

Cheers
Ulf

Germany becoming the "wild card" in drug pricing

noreply@blogger.com (Unknown) — Tue, 18 Feb 2014 20:51:00 +0000

Dear Readers,

just saw this in the news (see link below). Germany is thinking of issuing a new law that the so far confidential price discounts be made public. That would be an entire new ballgame for the industry in Europe with potentially significant price erosions and spillover effects elsewhere.

Will keep an eye on that.

Cheers
Ulf

http://www.reuters.com/article/2014/02/18/us-germany-drugs-analysis-idUSBREA1H09E20140218

Critique on lower NICE threshold research

noreply@blogger.com (Unknown) — Wed, 04 Dec 2013 17:51:00 +0000

Hi everyone,

sitting here on my desk with a typical December cold, I came across this critique from the OHE of something that gives me even more headaches when reading it. I can't resist giving my 5 cents to it. Seems like Claxton and colleagues have proposed a new NICE threshold of £12,936 ... wooooow and how accurate! I am amazed how politely and scientific the OHE responded to that. My critique is much simpler and less kind: total rubbish!
With all respect for the academic credentials and experience of this group, but this tells me that someone has not understood the bigger things in life that are far more complex than putting forward such a silly paper (and number). I recommend reading a bit of Friedrich August von Hayek's key papers: "The pretence of knowledge" and "The theory of complex phenomena" before engaging in another round of "scientific" threshold analysis: Medicine is not physics, decision making about factors that affect health, physical well being and perceived quality of life etc. do not fit, and should not be decided based on, a foolish formula, full stop.

A good evening to everyone
Regards
Ulf

UK VBP - paddling back big time ?

noreply@blogger.com (Unknown) — Thu, 21 Nov 2013 09:37:00 +0000

Dear All,

it took some time for the UK government to come out with something on the VBP debate. Now the first details of the new "deal" emerged. What is now on the table looks quite different from what was set out as an objective, but not at all from what has been done so far. Of course we are not surprised knowing all along how difficult it is to implement something that sounds easy in theory. Pretty much everything stays the same, the threshold, NICE doesn't have a role in price setting apart from some wider benefits to the society are now supposed to be included in the assessment of new drugs.

Below a bit of reading on the topic.

Cheers
Ulf

http://blogs.nature.com/news/2013/11/uk-backs-away-from-value-based-pricing-for-drugs.html
http://www.pharmexec.com/pharmexec/Noteworthy/What-Does-the-UKs-New-PPRS-Mean-for-Value-Based-Pr/ArticleStandard/Article/detail/828958?contextCategoryId=48158

Survival and spending on cancer care in the EU

noreply@blogger.com (Unknown) — Sun, 29 Sep 2013 08:40:00 +0000

Dear All,

a new study has been presented at ESMO in Amsterdam. Researchers presented data on cancer spending in relation to overall mortality across the European Region. Not surprisingly confirming the relation between poor investments in cancer care and overall outcomes.

Cheers
Ulf

"No hour" week...

noreply@blogger.com (Unknown) — Tue, 11 Jun 2013 10:39:00 +0000

Hi All,

today a post a little off our topic here but most important. Patti from healtheconomics.com posted this link, which I find very interesting. Its about flexibility in your daily working considering our times of modern technology and connectivity. It just hit it right on the head, I remember working in big corporate headquarters occasionally sitting around in endless meetings where some of them appeared to be dictated to beating time or because they were in some sort of agenda or somebodies annual objectives... there is only so much to say in endless weekly market access meetings when your product is still 3 years away, is there..?

So this article was refreshing, indeed within pharma we need a mindset like that, treat people like adults and work on the important stuff with focus, passion and dedication and cut out the dead wood. Go for a round of mountain bike to start the day and do something right later in the office rather than pester people around the globe with the x update of the update at 7 a clock in the morning.

The other topic is remote working, motivated and dedicated workers will perform well weather they sit an office or on their terrace at home - at this level childish control is counterproductive. Yet I was surprised to hear when Yahoo's new CEO decided to ban remote working. Most ridiculous, at least in my view, was the argument that best ideas and solution come from the talks in the floor around the coffee machine. A phrase that is totally overused and as I believe also fundamentally wrong. What people do at such encounters is engage in latest company gossip.. Best ideas come from motivated, happy, engaged and well rewarded employees that can identify themselves with their company and products and are treated in a way that allow them to flourish professionally, shift their work around their style, e.g. no use to force a night owl at 7am in the office etc..

I like and already live that concept and, yes, it does work very well but so far mostly in smaller companies although a very few of the bigger ones are already further ahead as well.

Have a nice day
Cheers
Ulf

VBP event September 24-26 London

noreply@blogger.com (Unknown) — Tue, 28 May 2013 13:46:00 +0000

Dear All,

VBP in the UK is around the corner and Hanson Wade (see post below) have invited Olivier and myself to run a pre-conference workshop on VBP. Looking forward to seeing many of you!

Best wishes
Ulf

At Value Based Pricing (24 - 26 September, London) authors of The Future of Health Economics, Ulf Staginnus and Olivier Ethgen will be leading an introductory workshop to get you up to speed on the considerations and implications surrounding value-based pricing. This interactive session will enable you to practically implement value-based strategies into your drug development programmes and ensure you meet the growing demands of payers around Europe.

Attend their interactive half-day workshop to:

Explore what a VBP structure will mean for the UK - get to grips with the changing pricing structure and understand how it relates to other EU countries
Evaluate the practicalities of incorporating VBP into your strategies and realise what is achievable for your portfolios
Understand how value can be defined and whether it should be consistent across disease indications and patient populations
Discuss international reference pricing in relation to value-based pricing

Download the brochure to see the full Value Based Pricing agenda and information on the other 2 workshops.

Following on from the workshop day, Value Based Pricing will feature companies working across Germany, France, Switzerland, The Netherlands, Belgium and the UK openly sharing their experiences of developing value-based pricing strategies, preparing you for the impending pricing changes in the UK.

This meeting represents your greatest chance to be as prepared as possible for a value based pricing system in the UK and across Europe. Join your peers at Bayer, Vifor Pharma, Novartis, Ipsen Pharma, InterMune, GSK, Merck Serono, Takeda, Bristol-Myers Squibb, Pfizer and Amgen among others.

Register before Friday 28th June to save up to £300 off standard rates. To secure your place, visit: www.valuebased-pricing.com/register

Best wishes,

Emma

Emma Hosgood

Programme Director

Hanson Wade

www.valuebased-pricing.com

Oncologists critizise cancer drug pricing in the US

noreply@blogger.com (Unknown) — Fri, 26 Apr 2013 12:18:00 +0000

Dear All,

a recent paper in Blood sharply criticizes the pharmaceutical industry for the prices of cancer (CML) drugs. I am a little surprised that they have started to hinge the debate so much on Gleevec maker Novartis Oncology. Among all the newer cancer drugs that is certainly not at all an example of over pricing, considering the tremendous benefits that this drug has brought to CML patients. Its pricing, especially compared to other cancer drugs nowadays was actually rather modest. In addition, in Europe (already in some markets) and the US it is available off patent soon. (Net) Price increases have certainly not happened in Europe and the cited US increase surprises me as well as we know net pricing is a different story. Anyhow, they do have a point however on other occasions and it is therefore important to move away from the price per pill concept and discuss and establish innovative pricing models that meet the interest of all stakeholders involved, especially those that are linking the financials closer to the actual benefits delivered over time.

Cheers
Ulf

NICE to run VBP in the UK

noreply@blogger.com (Unknown) — Sat, 23 Mar 2013 17:40:00 +0000

Dear All,

now its out - NICE is broadening its role and will take on additional responsibilities as part of the VBP system in 2014.

Some links on the matter:

http://www.pharmafield.co.uk/Pf-Fox-News/NHS/2013/03/NICE-will-have-key-role-in-value-based-pricing

http://www.pmlive.com/pharma_news/nice_will_take_central_role_in_uks_value-based_pricing_system_468733

http://www.pharmatimes.com/Article/13-03-22/NICE_given_central_role_in_VBP_scheme.aspx

Cheers
Ulf

The UK NHS struggles to implement VBP

noreply@blogger.com (Unknown) — Thu, 14 Mar 2013 16:58:00 +0000

Dear All,

an interesting article from the Financial Times elaborating on the issues around VBP. It doesn't surprise me at all that they find it difficult to implement such a system. Indeed the danger is that VBP becomes a buzzword if things are left unclear and do not progress well. Interesting to see the German system is being eyed on, it does make more sense to move towards some sort of "negotiation based approach" relying on multiple criteria after a clinical appraisal rather than trying to square the circle with some sort of modified QALY threshold system. About two years ago I brought some of the top academics together to think about what a VBP could look like and I remember how difficult it was to get a bunch of real experts on pricing matters to agree on something that can be made operational. In the end of the day it maybe not so different with some form of price/profit control a la the PPRS plus some sort of system that expands on the cost/QALY threshold a little. Interesting for sure how this will unfold further.

Cheers
Ulf

Spanish Ministry warns of excessive pricing of cancer drugs

noreply@blogger.com (Unknown) — Sat, 23 Feb 2013 12:02:00 +0000

Dear All,

in a recent newsletter BCN health outlined that the Spanish Ministry is getting increasingly wary of too high prices on cancer drugs. They have stated that if the products fail to demonstrate cost-effectiveness they will not be funded by the NHS. Various drugs are stuck in the Spanish Ministries' pricing commission.
Indeed I also saw a lot of articles recently on the new pricing system to be implemented. Some lawyers talk about the need of an "entire new house" for the system of drug price setting in Spain. Clearly the involvement of more economic analysis in terms of cost effectiveness and budget impact will be part of it. I believe reference pricing will also play an import role coupled with more risk sharing that we see emerging in certain communities. The bigger pricing threads comes from those who like to introduce more centralized tender purchasing.

There are no signs of recovery of the Spanish economy hence serious pricing pressures will continue throughout 2013 and beyond.

Cheers
Ulf

Recordings eyeforpharma AMNOG webinar

noreply@blogger.com (Unknown) — Fri, 08 Feb 2013 20:06:00 +0000

Dear All,

just got the word from eyeforpharma that the webinar on how to overcome the AMNOG hurdles to achieve access in Germany’s market was a great success last week. They’ve just finished putting together the recordings for you.

Over 400 people listened to the payer panel as Dr. Mathias Flume, Physicians Association, Westphalia-Lippe, Dr Detlev Parow, Statutory Health Insurance, DAK Deutsche Angestellten Krankenkasse and Andreas Guhl, Founder, ValueMAxes shared exclusive insights with the audience.

You can check out the recordings here

Cheers
Ulf

HEOR Consultant Basel, Switzerland

noreply@blogger.com (Unknown) — Fri, 01 Feb 2013 17:09:00 +0000

Dear All,

this is a current search, please contact Theo (below) if interested.

Cheers

Ulf

As the Health Economics and Outcomes Research market continues to grow, this global consultancy is seeking an organised and experienced individual to lead teams and work within a stimulating environment as a HEOR Consultant. Based in Switzerland, you will possess a profound knowledge of HEOR and will have experience of working within the pharma and healthcare industry.

Being part of a fast-growing and highly successful division, you will focus upon delivering tangible business results to clients and business managers across the international pharmaceutical and healthcare industries. You will also be heavily involved in outcomes research, economic analysis and the natural history of a disease, HEOR consultants will work with a diverse mix of clients, typically including the global top 20 pharmaceutical companies.

Responsibilities:

- Reviews and analyses client requirements in order to help develop proposals for cost-effective solutions
- Organises and conducts high quality research for clients with input and review by colleagues
- Has a thorough knowledge of consulting methodologies and the health care sector
- Contributes to the development of value dossiers and support material for clients
- Engagement based responsibilities are assigned and managed by senior consultants, engagement managers or principals
- Performs outcomes research, health economic analyses or environment analyses to assist in the identification of client issues and the development of client specific solutions
- Supports systematic review and meta analysis projects

Qualifications:

- BA/BSc in science or economics or related discipline essential
- MSc/MPhil/PhD in economics/health economics health services research or a relevant related area

Experience:

- Post-graduate work experience in a related area (such as economics, health economics, statistics, psychology or science)
- Experience in undertaking economic analysis (in either Pharmaceutical or other Healthcare Industry, Academic Organisation, HTA Group, or Health Services Research).

Successful candidates will be fluent in English and possess strong business/scientific written. Having strong written and verbal communication skills, they will have the ability to build strong consultative business relationships. Being able to deliver high quality work with strong attention to detail is crucial. An established net work of referrals and contacts is advantageous

To apply, or for further information, please contact Theo Rowley on +44 (0) 207 440 0679 / t.rowley@proclinical.co.uk. Alternatively, contact him via LinkedIn.

noreply@blogger.com (Unknown) — Mon, 28 Jan 2013 16:20:00 +0000

...this I just saw on the BBC website, made me smile, especially the comment from Dr. Walker - he is definitely right in saying that it didn't need a big study to 'proof' that QALY's have many issues... I suppose researchers may compare to the alternative systems in Germany and France over time..

Researchers claim NHS drug decisions 'are flawed'

By Jane DreaperNICE decides which drugs are cost effective on the NHSHealth correspondent, BBC News

The formula used by the NHS to recommend which drugs should be funded is "flawed" and should be scrapped, researchers say.

The European Commission-funded study tested the assumptions of the system used by NICE (the National Institute for Health and Clinical Excellence).

Researchers concluded the watchdog's system failed

to reflect variations in views on illness and disability.

NICE called the study "limited" and said the measure it used was the best.

NICE uses a method called quality-adjusted life years (QALY) for assessing the value of new drug treatments in England and Wales. A similar system is used by the Scottish Medicines Consortium (SMC).

The formula looks at the cost of using a drug for a year and weighs it against how much someone's life can be extended and improved. Generally if a treatment costs more than £20,000-30,000 per QALY, it would not be recommended as cost-effective by NICE.

“Start Quote

"This isn't a scientific way to classify and prioritise the drugs - mathematically, it's totally flawed.”

Ariel BeresniakResearch leader

The European Consortium in Healthcare Outcomes (ECHOUTCOME) researchers will present their findings at a conference in Brussels on Friday.

Their work has already prompted a backlash by UK-based experts, who defended the current system for making decisions.

The researchers analysed a detailed questionnaire with more than 1,300 respondents - including 301 in the UK.

Their findings criticised the QALY system for grading different states of health. The researchers said people varied in their views about the impact of different levels of illness or disability, and in their approach to risk.

They also found that people's willingness to sacrifice remaining years of life in order to have better health varied enormously over different periods of time.

The researchers said 71% of the respondents would prefer to live 15 years in a wheelchair than die after 10 or five years in a wheelchair - but the remaining 29% said they would prefer to die earlier rather than spend 15 years in a wheelchair.

The project leader, Ariel Beresniak, a French doctor and economist who used to work in the drug industry, said: "Important decisions are being made on the basis of QALY, but it produces the wrong results.

"This isn't a scientific way to classify and prioritise the drugs - mathematically, it's flawed.

"We think it is time to open this debate, particularly as some of the newer European countries are trying to organise their health assessment systems and might be considering QALY.

"NICE has made negative recommendations about many major innovative drugs, based only on arbitrary incremental cost per QALY.

"Agencies such as NICE should abandon QALY in favour of other approaches."

Cost-benefit approach

A similar method is used by Canada and Australia for assessing new treatments.

The researchers suggest instead using a cost-benefit approach - such as how many cases of remission a drug can provide, or how many relapses it might prevent.

A NICE representative said: "We need to use a measure that can be applied fairly across all diseases and conditions. The QALY is the best measure anyone has yet devised to enable us to do this.

"It's developing and improving all the time and the criticisms in this rather limited study haven't shaken our confidence in its value to NICE in helping make decisions on the best way to use new and sometimes very expensive drugs and other health technologies."

John Cairns, professor of health economics at the London School of Hygiene and Tropical Medicine and a member of the NICE's appraisal committee for 10 years, said: "QALYs are certainly not perfect and we should be looking for better ways of informing decision making.

"But getting rid of an imperfect system without replacing it with a better one is not the way forward."

Dr Andrew Walker, an economist at the University of Glasgow, with 10 years' experience of reviewing new medicines at the SMC, said: "I am amazed it has taken these authors three years and one million euros to establish what we already know, that QALYs are not perfect.

"Anyone who makes decisions using QALYs and who cannot think of at least three issues with them is not thinking hard enough.

"As an alternative they propose cost per remission in arthritis, but I ask them to tell me how they define remission, how long remission lasts and how much we are willing to pay for one remission.

"If we want to spend more on cancer medicines, it has to come from somewhere. The researchers speak as though there were no budget limits."