Planning With Payer Insights: Even the Best Economic Models Need Validation

In today's healthcare payer landscape, characterized by evolving pricing thresholds and Health Technology Assessment (HTA) requirements in markets where economic models are a critical element of a submission, a well thought model concept with appropriate input parameters for model implementation are critical to increase the likelihood of success and obtain a favorable reimbursement decision.

Economic models play a crucial role in demonstrating the value of a new product at launch in HTA markets. To accurately illustrate incremental value of a new product relative to the standard of care (i.e., comparator), and evaluate its cost effectiveness in a specific population, health economists must navigate through many input parameters to implement in the economic model, as well as conceptualize the model framework, optimal for the product at hand.

This HEOR Theater presentation will explore the benefits of an integrated, cross-functional approach that incorporates payer insights upfront to inform and validate economic model framework and inputs from various sources which include clinical trials and real-world evidence. The session will demonstrate how this approach of planning for payer insights at various stages of economic model development enhances the likelihood of success and drives impact in reimbursement decisions. Speakers from the economic modeling consultancy and life sciences industries will share examples illustrating this concept.

By uniting economic modeling methodology and practical payer perspectives, the presenters aim to provide a comprehensive framework for developing robust economic models that stand up to scrutiny in the access and reimbursement environment. This approach will assist life sciences companies to avert the scenarios of heavy criticism and illustrate how insight-based economic model development may have helped.

Sponsor: Genesis Research Group