Value Attribution Frameworks for Combination Treatments: Are They a Viable Solution to Solving the Market Access Challenges?

ISSUE: Patient access remains challenging given the legal challenges inhibiting cross-company dialogue, the difficulty of attributing appropriate proportional value to the individual components of combination therapies, and the monotherapy-dominant paradigm employed in HTA processes and negotiations. To address the value attribution challenge, two value attribution frameworks have been developed (Briggs, et al. 2021; OHE, 2022). These frameworks attempt to define value via formulaic approaches; however, they have been developed for cost-effectiveness markets, particularly with the UK context in mind, where an explicit threshold exists. Further, they only address one component of the issue and require integration within a broader approach encompassing other solutions to address legal and reimbursement challenges. As HTA bodies contemplate the relevance and operationalisation of these frameworks within local methods and processes, careful consideration is warranted to inform their role within a comprehensive set of solutions to a complex challenge. Many questions require consideration: Are they applicable to non-cost-effectiveness markets? Can they be embedded in existing value frameworks and processes? What in addition is required for their implementation?

OVERVIEW: Panel will commence and end with an interactive poll to engage the audience. Speakers from multiple perspectives will be invited to discuss the merits and limitations of two proposed value attribution frameworks, which will be introduced by Jennifer Gaultney (5 minutes). The industry point of view will be presented by Celine Fernandez, representing a manufacturer of emerging oncology combination treatments (12 minutes). Professor Steven Simoens will present a technical critique of the proposed frameworks and their implications in practice (12 minutes). Dr. Dan Ollendorf will present the HTA perspective on the solutions to address the challenges and the role a value framework could have within HTA (12 minutes). A question and answer session will follow each panelist presentation. Panel ends with key take-aways and a concluding polling of the audience.