2.3.2 British Criteria for Cancer Drug Payment

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來自 University of Minnesota 的課程

Pharmaceutical and Medical Device Innovations

229 個評分

University of Minnesota

Pharmaceutical and Medical Device Innovations

229 個評分

課程 3（共 5 門，Specialization 医疗市场）

This course in the Healthcare Marketplace specialization gives the learner an in-depth view of the intellectual property creation that is vital to creating breakthrough technologies. Included is an understanding of the strategy deployed for pricing drugs and new technologies as well as the market sizing exercise to identify where future research and development investments should be made.

從本節課中

Pharmaceutical Market Deployment & Management

In this module you will learn about how the pharmaceutical industry takes a product that has cleared the bench and sells it in the market. Pharmaceutical marketing of a drug product is one of the most complex consumer behavior activities in practice today. Selling a new drug in a highly competitive global market space with a patent clock ticking is a constant tactical game played out on a long strategic clock that also runs into subsequent generic deployment. The take-away messages from this module are the pharmaceutical market requires strategic thinking that considers an array of contingencies. The market also must be nimble to adjust to different government policies that can create or break decades long product lines and therapeutic interventions. The skills gained from this module are an understanding of the competitive landscape analysis as well as threat assessment analysis required to complete the capstone medical innovation project.

2.3.1 Trends in Cancer Drugs5:14

2.3.2 British Criteria for Cancer Drug Payment6:48

2.3.3 U.S. Criteria for Cancer Drug Payment7:44

與講師見面

Bryana Mayer
Lecturer
Carlson School of Management, Medical Industry Leadership Institute
Stephen T Parente
Professor
Carlson School of Management, Department of Finance

This is Module 2.3.2, British Criteria for Cancer Drug Payment.

I'm Stephen Parente, Professor, Department of Finance.

In our prior lesson, we talked about the qualities of said life here saved and

how that was used as a criteria in the UK, as well as the US system.

In this module, we're going to be talking about NICE and,

specifically, this National Institute for Clinical Excellence.

Originally it started out in 1999.

Its name actually has changed a little bit, but everyone keeps on calling it NICE

as it goes on, for example, in 2005 it gained a few extra words,

National Institute for Health and Clinical Excellence.

So, the idea behind NICE is that it's a quasi governmental organization

that is funded by the UK government.

That basically looks at whether or not,

not just pharmacological procedures, but also procedures,

devices, diagnostic technologies are appropriate for

payment within the NHS, the National Health Service of the British of the UK.

Now in 2006, there was a new process introduced with NICE,

otherwise known as Single Technology Assessment, or STA.

This was, essentially, working with the previous NICE process,

whereas looking at Multiple Technology Appraisal and photos,

now everything will be looked at independently.

In 2010, the government changed in the UK,

combination of a conservative coalition government coming into play.

These QuANGOs were otherwise known as, basically,

these quasi organizations or really, NGOs,

non-governmental organizations, and NICE was one of those and it actually survived.

Many of them went down at that period of time.

At that time also, NICE took over responsibility of actually

making distinctions for what would be covered or not.

Then again, the name changed again, but still people liked to call it NICE.

2014 brought in the notion of actually using value based pricing, but

the implementation was not quite clear exactly what that structure will be.

Now when we look at how NICE guidance actually works,

there is the central goal of developing NICE guidance.

But it actually falls into, basically, three different centres.

The Centre for Public Health Excellence,

which looks at different public health interventions, and such.

The Centre for Technology Assessment, which does the proper technology

appraisals, that's usually where most of the pharmaceutical and

medical device components are going to fall.

And then the Centre for Clinical Practice,

which talks about the application of those technologies that are commonly used.

Now, in terms of the criteria that are used for

whether a procedure is covered or not, one thing is rarity.

That is, is this a big enough population or is it too small?

Is there any sort of alternative treatment that's comparable benefit that's available

through the British National Health Service?

Life expectancy, this is kind of a sad one, actually.

So the idea is that if something, someone is going to have a relatively short life

expectancy, that might be a major concern about whether it's appropriate to extend,

and then survival benefit.

Is there sufficient evidence to indicate that the treatment offers

an extension of life,

normally at least three additional months compared to the current NHS treatment?

So here are some NICE decisions under

what was used as the end of life criteria developed there.

And so the threshold for these different drugs that are being looked at here,

was the $50,000 per quality threshold.

The thought being that if things are falling at the end of life,

it might be too expensive to cover, and so

these drugs here might not necessarily make the cut.

Whereas these would be, potentially, okay to extend someone's life and

actually enhance their quality.

So the current approach that actually gets used when figuring

out that the stakes are covering between 20,000 and 50,000, but

generally anything between 20 and 30 is covered.

The thought is that there's the innovative nature of the technology that's looked at,

whether or

not there are any non-health objectives of the NHS that you've considered.

HRQoL's known measure of actually looking at health status to see if that's

improved.

And then beyond this $30,000 threshold, the question is whether or

not you're actually extending treatment at the end of life and

if you're doing it in a way that is meaningful,

then that might be considered per payment up to $50,000 per quality.

More challenging, now there's a new approach that's actually been developed

per NICE for these criteria as well, that actually spans the whole continuum.

This considers burden of illness, the wider social impact, the technology again,

looking at health status, how innovative the technology is, and

then the non-health objectives.

If you notice, the end of life criteria is not in play.

An interesting study that came out just recently in the Journal of

Health Economics, 2013, actually looked at societal views on NICE and cancer drugs.

And found some pretty interesting criteria about what, essentially, a population of

adults in Great Britain said about what they consider to be the priorities.

Because on the one hand, these priorities are being set by, basically,

an organization like NICE.

And they're smart people, they're relatively informed.

The thought is, what does the population think?

And so the interesting thing, using a survey in methodology, was that they

found the population supported using the following criteria for payment.

Where there's a severe disease, it's unmet need, it's innovative,

which was covered before, and there could be wider social benefits.

But there was not support for priority for end of life, for children, for

disadvantaged groups or for cancer, which is surprising, because these

are the things that are frequently cited as, you need to have access to services.

But, they really weren't the core, and again, NICE is a political process,

and when we'll see how these results will go into resetting the criteria for

NICE in the future, particularly as it pertains to cancer medications.

This concludes this module on cancer medications as an illustration of

the pharmaceutical market.

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