The Explosion of Innovative, New Therapies and Payers’ Crisis of Affordability
New Orleans, LA, USA—May 22, 2019—ISPOR, the professional
society for health economics and outcomes research (HEOR), held its final
plenary of the ISPOR
2019 annual
conference with, “Is Healthcare Affordability Driving a Need to Revolutionize
Drug Pricing?”
The recent surge in the
development of new, innovative drugs is an exciting time for many. This era of
innovation has brought the promise of a cure for a number of diseases. These
novel therapies, however, come at a high cost and includes 6-figure cancer
therapies, expensive “orphan” drugs that treat rare diseases, and even some high-priced
drugs for more common diseases. This has resulted in a crisis of affordability
for payers who must now contend with budget impact issues for these high-cost
therapies. The ISPOR 2019 Top 10 HEOR Trends report identified drug
spending and pricing as the number 1 trend for this year. In the United States,
President Trump launched his Blueprint to Lower Drug Prices in May 2018, and a
recent paper from the University of Chicago reported that average total drug
spending per hospital admission increased 18.5% between 2015 and 2017.
Affordability of pharmaceuticals has become a global issue.
Panelists included Muna
Bhanji, RPh, Merck, Philadelphia, PA, USA; Meindert Boysen, PharmD, MSc, National
Institute for Health and Care Excellence, Manchester, England, UK; Colleen M. Flood;
University of Ottawa Centre for Health Law, Policy and Ethics; Ottawa, ON,
Canada; Louis P. Garrison, Jr, PhD, University of Washington, Seattle, WA, USA;
and Mark Trusheim, MS, NEWDIGS and Massachusetts Institute of Technology, Cambridge,
MA, USA.
The session was moderated
by Ms Flood who generated a lively discussion from the panel. Dr Garrison stressed
that medicines are global public goods and that we need to find a way for
everyone to appropriately contribute to the pool of innovation that brings life
saving drugs to market. He noted that the pricing of drugs often does not
reflect their true value. Mr Trusheim advocated for “precision pricing” that employs
appropriate variability in pricing of drugs. This approach would price drugs
for every patient based on the value they receive—a customized price. Ms Bhanji
pointed out that we now live in a transformative era where diseases that were
once a death sentence are now chronic conditions. She focused on the importance
of addressing inefficiencies in the healthcare system since it is estimated
that 30%-40% of healthcare spending is inefficient. She stressed that even a small
improvement in reducing this inefficiency could result in huge savings to the
healthcare system. Dr Boysen spoke about how NICE focuses on the value side of medicines,
eg, quality-adjusted life years (QALYs). In contrast, payers focus on affordability
and assess the budget impact of new medications to determine their impact on budgets.
He believes that discussions related to pricing, value, and affordability need
to be had much earlier in the process than is currently happening.
ISPOR is recognized globally as the leading
professional society for health economics and outcomes research and its role in
improving healthcare decisions. ISPOR 2019 is the leading global HEOR
conference and draws nearly 4000 healthcare thought leaders and stakeholders,
including researchers and academicians, assessors and regulators, payers and
policy makers, the life sciences industry, healthcare providers, and patient
engagement organizations.
Additional information on the conference can be found at:
Conference Information | Program | Registration | Short Course Program | Sponsors | Exhibitors | Press
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ABOUT
ISPOR
ISPOR, the professional society for health economics
and outcomes research (HEOR), is an international, multistakeholder, nonprofit
dedicated to advancing HEOR excellence to improve decision making for health
globally. The Society is the leading source for scientific conferences,
peer-reviewed and MEDLINE®-indexed publications, good practices
guidance, education, collaboration, and tools/resources in the field.
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