What this event achieved?
Payers, both public and private, have never before faced such extreme budgetary pressures. Many health systems face the “perfect storm” of ageing populations, weak economies and and rapidly increasing healthcare costs in general, including the sustained cost increases of innovative and novel drugs and technologies. Health Technology Assessors (HTAs) are having to make difficult decisions on the true “value” of drugs and devices, often with limited evidence that they offer improved health outcomes. Even if a drug is deemed to be “cost-effective” and relative to other therapies, affordability still poses a dilemma for payers. This is forcing payers to make difficult choices regarding which medical procedures & medications to fund and reimburse. No longer are “me too” drugs simply approved for reimbursement at high prices. Payers need to make tough decisions based on what they define as “value”, unfortunately sometimes at the expense of funding treatments in some “lower priority” disease indications or individual patients. Despite intense political pressure, the reality is that payers have a finite and limited budget and face a high-degree of risk in decision making. It is increasingly difficult for payers & HTAs to make the right decision in a high-risk, high-uncertainty environment. Various options and decision-making tools exist, some old, some novel. Traditional tools based on, for example, price referencing, DRGs or generic substitution are still significant. However, recent advances in the sophistication of HTA methodologies, health economic analysis and modeling, flexible pay-for-performance models, risk-sharing and value-based pricing have become increasingly important to mitigate payer risk and allocate financial resources to the areas of pressing need. Moving forward, reimbursement will be increasingly prioritised towards areas of high-unmet need and improved health outcomes.
Why this meeting?
This meeting provided an ideal opportunity for “payers” and other decision makers from both public and private organisations, to benchmark with peers internationally and provide pharma companies an invaluable insight into the decision-making processes, and methodologies of these vital stakeholders. Attendees will be able to understand and develop “best practices” with the ultimate goal of encouraging innovation and improving patient access to novel and powerful medications.