Health Economics Increasingly Inputs into Clinical Development

Payer demand for value indicators that can guide compensation conclusions are prompting top pharmaceutical companies to increasingly request input into clinical development from their health economics department, according to a new study.

While clinical data is fundamental in driving reimbursement decisions, companies that only evaluate finished clinical trial data to determine a product’s economic benefit “typically face difficult questions from payers,” the report observed.

At 15% of the top 20 pharmaceutical companies who were surveyed for the research study, Health Economics and Outcomes Research: Aligning Clinical and Commercial to Meet Payer Demands and Win Reimbursement, health economics experts work closely with their co-workers running clinical trials, the report by Cutting Edge Information found.

Health Economics and Outcomes Research (HEOR) departments are the best resource for determining outcomes of interest to payers, the report comments.  Clinical development colleagues may already be looking for input once a drug is in Phase III development.

Michelle Vitko, senior research analyst at Cutting Edge Information, noted that “testing a product against a placebo may lead to regulatory approval in some cases, but it is unlikely to be sufficient for reimbursement.”

“Payers want to see that a product effectively treats a disease and that the average patient’s product use will lead to a better outcome than other products,” she added.  “Ideal outcomes lead to fewer doctor visits, a shorter hospital stay or lower rates of complication, all of which are expensive for payers.”

However, the study revealed that clinical development teams are more likely to use the HEOR team’s input when clinical trials are designed for the US or major European markets.

The requirement for teamwork between the different teams will increase as payers become more precise about the information needs shaping their reimbursement decisions, the analysts believe.


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