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title (capital letters)
discussion leaders
no more than 4–please include name(s), degree(s), position(s), institution(s), city, state and country
workshop purpose
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workshop description
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THE COST-EFFECTIVENESS THRESHOLD: A HURDLE FOR INNOVATION? |
Discussion Leaders: Mark JC Nuijten, MD, PhD, MBA, Consultant, Ars Accessus Medica/Erasmus University Rotterdam, Amsterdam, The Netherlands; Rogier M Klok, PharmD, PhD, Health Outcomes Officer, Wyeth Pharmaceuticals, Hoofdorp, The Netherlands; John Hutton, PhD, Professor of Health Economics, Centre for Health Economics, University of York, York, UK
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PURPOSE: The aim of this workshop is to explore the potential negative impact of the use of a cost-effectiveness threshold on innovation, when taken into account a long-term societal perspective.
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DESCRIPTION: The impact of cost-effectiveness data in the health care decision-making process has been increasing over the last 5 years leading already to formal requirements in a number of countries. In their decisions on paying or not for new drugs and technologies, decision makers apply - either explicitly or implicitly – a threshold for an acceptable incremental cost-effectiveness ratio, often the cost per QALY. Therefore a clinically innovative drug may not be reimbursed because of an unfavourable assessment of its cost-effectiveness. As a consequence cost-effectiveness outcome is a decision criterion that affects patients' lives and medical communities' capacity to deliver optimal health care. However, the lack of sales of the new drug may also have a negative impact on R&D investment by the pharmaceutical industry. As a consequence this reduction of innovation will reduce the development of future drugs, which may have a substantial superior clinical benefit and cost-effectiveness compared with the current treatments. In this workshop we illustrate that the use of cost-effectiveness outcomes for the reimbursement decision, is ignoring the potential future societal values resulting from market access of new drugs, which is not captured in the incremental cost-effectiveness ratio. The concept is illustrated for biologicals. Would biologicals have been available for all current indications, if the cost-effectiveness ratio would have been a formal requirement for reimbursement at time of launch for the first indication?
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