Implementing a Value-Based Contract for Hereditary Angioedema Prophylaxis in Colombia: A Real-World Case Study...
Author(s)
Lorena Canon, MSc, MD1, Ivan Dario Arboleda, PharmD2, Marcela Daza, MSc, MD3, Andrés Navarrera, MD4, Ana Cristina Ochoa, MD, MBA5.
1Market Access Lead, Takeda Colombia, Bogotá, Colombia, 2TAKEDA, Bogota, Colombia, 3Takeda Colombia, Bogota, Colombia, 4Immunology TAL, Takeda Colombia, Bogotá, Colombia, 5Medical Affairs, Takeda Colombia, Bogota, Colombia.
1Market Access Lead, Takeda Colombia, Bogotá, Colombia, 2TAKEDA, Bogota, Colombia, 3Takeda Colombia, Bogota, Colombia, 4Immunology TAL, Takeda Colombia, Bogotá, Colombia, 5Medical Affairs, Takeda Colombia, Bogota, Colombia.
Problem Statement: In resource-constrained systems like Colombia’s, uncertainty around newer therapies can delay access and strain payer budgets. Regarding Hereditary Angioedema (HAE), a rare and serious condition, long-term prophylaxis (LTP) with innovative treatments was difficult to implement consistently across payers. Health-maintenance organizations (HMOs) required a payment model that could support access while aligning with real-world treatment patterns and financial responsibility.
Description: A value-based agreement (VBA) was established between Takeda and two HMOs to enable LTP access for HAE patients. It incorporated reconciliations supported by a pre-structured tool tracking vial-use, dosing-frequency, and cohort dynamics. Lanadelumab trials showed 44.4% of patients being attack-free after 6 months of treatment. With clinical stability, dose-interval extension—from every two weeks (Q2W) to longer intervals (>Q2W)—becomes viable.; this was reflected in the VBA. By April 2025, of 178 LTP patients, 71 (39.9%) received treatment within the VBA. Physician-led dose-interval extension based on clinical stability was achieved in 63.4% (n=45) of patients receiving >Q2W dosing, while 36.6% (n=26) continued Q2W dosing. Efficiency was measured comparing actual to expected monthly-drug use: of 142 expected doses (April-2025), 97 were administered: representing a reduction of -35.5% (HMO#1), -16.9% (HMO#2), and a system-wide efficiency of -31.7%. Monthly validation reports ensured real-time monitoring and transparency.
Lessons Learned: This case illustrates that real-world VBAs can align clinical and economic objectives. Addressing rare disease therapies requires shared accountability between the pharmaceutical industry and healthcare systems. Collaboration ensures equitable access to innovative treatments despite limited resources. VBAs provide sustainable financing approaches, emphasizing transparency, resource prioritization, and impactful interventions. Innovation must balance therapeutic efficacy and economic sustainability, prioritizing patients’ access to treatments that improve quality of life.
Stakeholder Perspective: This case reflects a joint payer-industry perspective demonstrating how structured real-world data, co-managed by HMOs and a pharmaceutical partner, can guide treatment strategies improving access in complex, high-cost conditions.
Description: A value-based agreement (VBA) was established between Takeda and two HMOs to enable LTP access for HAE patients. It incorporated reconciliations supported by a pre-structured tool tracking vial-use, dosing-frequency, and cohort dynamics. Lanadelumab trials showed 44.4% of patients being attack-free after 6 months of treatment. With clinical stability, dose-interval extension—from every two weeks (Q2W) to longer intervals (>Q2W)—becomes viable.; this was reflected in the VBA. By April 2025, of 178 LTP patients, 71 (39.9%) received treatment within the VBA. Physician-led dose-interval extension based on clinical stability was achieved in 63.4% (n=45) of patients receiving >Q2W dosing, while 36.6% (n=26) continued Q2W dosing. Efficiency was measured comparing actual to expected monthly-drug use: of 142 expected doses (April-2025), 97 were administered: representing a reduction of -35.5% (HMO#1), -16.9% (HMO#2), and a system-wide efficiency of -31.7%. Monthly validation reports ensured real-time monitoring and transparency.
Lessons Learned: This case illustrates that real-world VBAs can align clinical and economic objectives. Addressing rare disease therapies requires shared accountability between the pharmaceutical industry and healthcare systems. Collaboration ensures equitable access to innovative treatments despite limited resources. VBAs provide sustainable financing approaches, emphasizing transparency, resource prioritization, and impactful interventions. Innovation must balance therapeutic efficacy and economic sustainability, prioritizing patients’ access to treatments that improve quality of life.
Stakeholder Perspective: This case reflects a joint payer-industry perspective demonstrating how structured real-world data, co-managed by HMOs and a pharmaceutical partner, can guide treatment strategies improving access in complex, high-cost conditions.
Code
IC5
Topic
Health Service Delivery & Process of Care, Medical Technologies, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Rare & Orphan Diseases