ISSUE

: Financially driven decision tools are rigorous, time-consuming and onerous. Over time, the complexity of processes and information requirements for pharmaceuticals have grown as efforts are made to increase the precision of models, despite the inability to remove all uncertainties. Similar decision processes are rarely used in other aspects of health funding (or other areas of government expenditure). This may lead to disproportionate and potentially biased focus on driving efficiency from one area of the system.

Do such approaches, therefore, represent the most effective or efficient process for governments to provide patients with reimbursed access to innovative pharmaceuticals?

OVERVIEW

: Governments improving universal healthcare must balance availability with finite resources. For emerging markets, lacking in health infrastructure, pharmaceuticals can represent a high proportion of expenditure compared to developed systems. In considering how to evolve decision making processes, countries are increasingly relying upon financially driven approaches to make reimbursement decisions about pharmaceuticals. These include cost-effectiveness analysis, budget impact and more recently “opportunity cost”.

Whilst financially driven decision approaches offer the opportunity for short term budget control, the application raises questions about equity of patient access and consistency across health funding. This panel will consider the impacts upon various stakeholders and explore potential alternatives that accommodate constraining factors. The panel will discuss the changing nature of health technologies and how their adoption is affected by current decision making processes.

Short introduction from moderator (10 minutes):

• Discussion of pharmaceutical costs in health systems of different maturity/coverage.
• Trends in decision-making approaches for reimbursement decision making.

Guided Q&A with opportunity for audience interaction (50 minutes):

• Richard Vines will provide patient perspectives. Jasmine Pwu will represent payer perspectives. Christoph Glaetzer will offer the pharmaceutical industry perspective.