WHAT IS THE APPROPRIATE DISCOUNT RATE IN ECONOMIC EVALUATIONS OF GENE THERAPIES (GT)?
Author(s)
Velikanova R1, Clay E2, Thokagevistk K2, Aballéa S3, Toumi M4
1Asc Academics, Groningen, GR, Netherlands, 2Creativ-Ceutical, Paris, 75, France, 3Creativ-Ceutical, Rotterdam, Netherlands, 4Aix-Marseille University, Marseille, France
Presentation Documents
OBJECTIVES: In economic evaluations, discounting adjusts future costs and benefits to present values. The nature of the distribution of costs and benefits was felt likely to make the estimation of cost-effectiveness particularly sensitive to decisions about appropriate discount rates. The objective of this paper is to highlight the discussion of discounting in economic evaluations of GT and provide a solution on whether the future costs and benefits should be discounted at the same rate, and what the optimal discount rate should be. A comprehensive empirical and theoretical literature search was conducted around the use of discounting. DISCUSSION: Uniform discounting is supported by the consistency thesis and the postponement paradox. It is believed that differential discounting will create inconsistencies in health economic analyses and will postpone the GT technology introduction. There are two competing theories regarding the proper measure for the discount rate: the social opportunity cost (SOC) and the social rate of time preference (SRTP). The choice of the correct method depends on the preferences of lower taxes and more current private consumption (the SRTP view) or lower government debt, lower interest rates and more current private investment (the SOC view). SOC suggests a relatively high discount rate compared to SRTP. Overall, lower discount rates for GT could have a positive impact on the ICER and price of the GT for health care payers, and could subsequently provide incentives for the development of such high benefit therapies. CONCLUSIONS: Decision makers should reconsider their existing discounting methodology to ensure that it is compatible with the high up front investments and long term healthcare effects that GT faces.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
Code
PBI6
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Novel & Social Elements of Value, Pricing Policy & Schemes, Public Spending & National Health Expenditures
Disease
Genetic, Regenerative and Curative Therapies