CHANGING THE HEALTH TECHNOLOGY ASSESSMENT PARADIGM FOR COMBINATION THERAPIES
Recent advances in genomics are enabling the development of innovative and targeted therapies in a range of disease areas, particularly in oncology. Targeting antitumor immune response at multiple levels may prove more effective than monotherapy and pharmaceutical companies are increasingly seeking Health Technology Assessment (HTA) approval for innovative drugs used in combination. Due to the complexity and nature of innovative drugs (e.g. extended treatment duration due to delayed disease progression), companies face multiple challenges, including high-costs and establishing an appropriate pricing structure/strategy.
The growing potential for innovative combination therapies is likely to generate further challenges within reimbursement systems. In Europe, payers are faced with increasing budgetary pressure to improve their allocation of scarce funding. Similarly in the U.S., there is a growing willingness to take action against prices deemed excessively high.
This Takeda-sponsored symposium‘s key objective is to capture expert insights on how to overcome HTA challenges specific to brand-on-brand combination therapies in various disease areas, including oncology.
The panel will acknowledge the variability of current HTA practices (e.g. single cost-effectiveness threshold and/or the use of multiple criteria) in assessing high-cost combination therapies (oncology and combination oncology drugs), the factors driving these differences (e.g. national reimbursement systems, decision rules), the discrepancies in HTA outcomes (e.g. approved, rejected) across countries and the implications these may have on patient access to medicines.
European representatives will debate on how combination therapies are evaluated and identify the challenges experienced during the evaluation process, if any, in these respective markets. For example, in the UK, how does the use of cost-effectiveness thresholds impact on brand-on-brand combination therapies and what are the issues with this approach? The panel will discuss how best to price combination treatments, i.e. consideration of the combination cost or only the addition cost, based on each market's set negotiation methods/discounts? They will also consider whether implementing therapeutic-area specific threshold/multi-indication pricing are feasible and appropriate. The panel will also explore other potential approaches to harmonise the HTA process and discuss ways to make new therapies affordable to independent health care systems to ensure patient access to innovative drugs now and in the future.
• Are current HTA frameworks used to assess brand-on-brand combination therapies suitable and do these lead to unequal patient access between jurisdictions?
• What are the pricing and reimbursement challenges for high-cost brand-on-brand combination therapies?
• What are the implications of current HTA decision rules for pricing?
• What makes an effective pricing strategy in order to secure reimbursement of combination therapies in multiple markets?
• Are current frameworks sustainable in the future? How are these expected to evolve?
• Do HTA agencies need to use other approaches (e.g. therapeutic-area specific thresholds/multiple criteria) to assess combination therapies in oncology?